As a care provider, you play an important role in helping identify members who may have a social determinant of health that creates a barrier to health and wellness.
Social determinants of health are the conditions in which people are born, grow, live, work, and age. They include factors like:
- Access to health care and healthy food
- Education circumstances
- Employment and socioeconomic status
- Physical environment
- Social support networks
- Foster care
When you are providing services to our member and observe a social determinant of health that has an ICD‑10 code, please include the code(s) on claims you submit.
ICD-10 Codes to Identify SDOH*
Educational Circumstances
- Z55.0 Illiteracy and low level literacy
- Z55.1 Schooling unavailable and unattainable
- Z55.2 Failed school examinations
- Z55.3 Underachievement in school
- Z55.4 Education maladjustment and discord with teachers and classmates
- Z55.5 Less than a high school diploma
- Z55.6 Problems related to health literacy
- Z55.8 Other problems related to education and literacy
- Z55.9 Problems related to education and literacy, unspecified
Effects of Work Environment
- Z56.0 Unemployment, unspecified
- Z56.1 Change of job
- Z56.2 Threat of job loss
- Z56.3 Stressful work schedule
- Z56.4 Discord with boss and workmates
- Z56.5 Uncongenial work environment
- Z56.6 Other physical and mental strain related to work
- Z56.81 Sexual harassment on the job
- Z56.82 Military deployment status
- Z56.89 Other problems related to employment
- Z56.9 Unspecified problems related to employment
Occupational Exposure
- Z57.0 Occupational exposure to noise
- Z57.1 Occupational exposure to radiation
- Z57.2 Occupational exposure to dust
- Z57.31 Occupational exposure to environmental tobacco smoke
- Z57.39 Occupational exposure to other air contaminants
- Z57.4 Occupational exposure to toxic agents in agriculture
- Z57.5 Occupational exposure to toxic agents in other industries
- Z57.6 Occupational exposure to extreme temperature
- Z57.7 Occupational exposure to vibration
- Z57.8 Occupational exposure to other risk factors
- Z57.9 Occupational exposure to unspecified risk factor
Problems Related to Physical Environment
- Z58.6 Inadequate drinking-water supply
- Z58.81 Basic services unavailable in physical environment
- Z58.89 Other problems related to physical environment
Problems Related to Housing and Economic Circumstances
- Z59.00 Homelessness unspecified
- Z59.01 Sheltered Homelessness
- Z59.02 Unsheltered Homelessness
- Z59.10 Inadequate housing, unspecified
- Z59.11 Inadequate housing environmental temperature
- Z59.12 Inadequate housing utilities
- Z59.19 Other inadequate housing
- Z59.2 Discord with neighbors, lodgers and landlord
- Z59.3 Problems related to living in residential institution
- Z59.41 Food insecurity
- Z59.48 Other specified lack of adequate food
- Z59.5 Extreme poverty
- Z59.6 Low income
- Z59.71 Insufficient health insurance coverage
- Z59.72 Insufficient welfare support
- Z59.811 Housing instability, housed, with risk of homelessness
- Z59.812 Housing instability, housed, homelessness in past 12 months
- Z59.819 Housing instability, housed unspecified
- Z59.82 Transportation insecurity
- Z59.861 Financial insecurity, difficulty paying for utilities
- Z59.868 Other specified financial insecurity
- Z59.869 Financial insecurity, unspecified
- Z59.87 Material hardship due to limited financial resources, not elsewhere classified
- Z59.89 Other problems related to housing and economic circumstances
- Z59.9 Problem related to housing and economic circumstances, unspecified
Problems Related to Social Environment
- Z60.0 Problems of adjustment to life-cycle transitions
- Z60.2 Problems related to living alone
- Z60.3 Acculturation difficulty
- Z60.4 Social exclusion and rejection
- Z60.5 Target of (perceived) adverse discrimination and persecution
- Z60.8 Other problems related to social environment
- Z60.9 Problem related to social environment, unspecified
Problems Related to Upbringing
- Z62.0 Inadequate parental supervision and control
- Z62.1 Parental overprotection
- Z62.21 Child in welfare custody
- Z62.22 Institutional upbringing
- Z62.23 Child in custody of non-parental relative
- Z62.24 Child in custody of non-relative guardian
- Z62.29 Other upbringing away from parents
- Z62.3 Hostility towards and scapegoating of child
- Z62.6 Inappropriate (excessive) parental pressure
- Z62.810 Personal history of physical and sexual abuse in childhood
- Z62.811 Personal history of psychological abuse in childhood
- Z62.812 Personal history of neglect in childhood
- Z62.813 Personal history of forced labor or sexual exploitation in childhood
- Z62.814 Personal history of child financial abuse
- Z62.815 Personal history of intimate partner abuse in childhood
- Z62.819 Personal history of unspecified abuse in childhood
- Z62.820 Parent-biological child conflict
- Z62.821 Parent-adopted child conflict
- Z62.822 Parent-foster child conflict
- Z62.823 Parent-step child conflict
- Z62.831 Non-parental relative-child conflict
- Z62.832 Non-relative guardian-child conflict
- Z62.833 Group home staff-child conflict
- Z62.890 Parent-child estrangement NEC
- Z62.891 Sibling rivalry
- Z62.892 Runaway [from current living environment]
- Z62.898 Other specified problems related to upbringing
- Z62.9 Problem related to upbringing, unspecified
Other Problems Related to Primary Support Group
- Z63.0 Problems in relationship with spouse or partner
- Z63.1 Problems in relationship with in-laws
- Z63.31 Absence of family member due to military deployment
- Z63.32 Other absence of family member
- Z63.4 Disappearance and death of family member
- Z63.5 Disruption of family by separation and divorce
- Z63.6 Dependent relative needing care at home
- Z63.71 Stress on family due to return of family member from military deployment
- Z63.72 Alcoholism and drug addiction in family
- Z63.79 Other stressful life events affecting family and household
- Z63.8 Other specified problems related to primary support group
- Z63.9 Problem related to primary support group, unspecified
Problems Related to Certain Psychosocial Circumstances
- Z64.0 Problems related to unwanted pregnancy
- Z64.1 Problems related to multiparity
- Z64.4 Discord with counselors
Problems Related to Other Psychosocial Circumstances
- Z65.0 Conviction in civil and criminal proceedings without imprisonment
- Z65.1 Imprisonment and other incarceration
- Z65.2 Problems related to release from prison
- Z65.3 Problems Related to Other Legal Circumstances
- Z65.4 Victim of crime and terrorism
- Z65.5 Exposure to disaster, war and other hostilities
- Z65.8 Other specified problems related to psychosocial circumstances
- Z65.9 Problem related to unspecified psychosocial circumstances
* These are supplemental diagnosis codes and should not be used as the admitting or principal diagnosis code to indicate the medical reason for the visit.
We know these codes don’t address all social factors that affect health and wellness. For now, please use the established codes, which provide an opportunity for us to collect, understand and address some of your patients’ SDOH.
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform.
|