Q: As you stated: There is update about the guideline I.B.14 Documentation by Clinicians other Than the Patient’s Provider. The Healthy People 2020 initiative of the US government also has information on the importance of this data at. The AHA has a document about the important of this data at. and state that codes describing SDOH should be assigned when documented. The guidelines for reporting SDOH can be found in section I.C.21.c.17. Q: Would you be able to share what the recommendation is for the coding of the social determinant codes and the benefit of coding these? My system is not looking to code these.Ī: The American Hospital Association encourages reporting of social determinants of health (SDOH) to track factors that influence the population’s health. Please note that the AHA/AHIMA updated the COVID-19 FAQs on August 27, 2021 and it is noted that code Z28.3, Underimmunization status, is not appropriate for reporting patients who have not had the COVID-19 vaccine. Code Z23 (Encounter for immunization) is only used when the reason for the current encounter is to receive the vaccine. Q: Are there any codes used to identify the patient has had the COVID vaccine? Immunization code?Ī: There is no code to identify that a patient has had the COVID-19 vaccine. If the patient also has an insulin pump, assign code Z96.41. Any time the patient is on insulin and is a non-type 1 diabetic, this note should be followed and code Z79.4 should be assigned. Q: Would you code long term use of insulin and hypoglycemic as well as presence of insulin pump?Ī: The code categories for diabetes, other than category I10 for type 1 diabetes, has a “use additional code” note indicating that the type of control (i.e., long term use of medications) should also be assigned.
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