Social Determinants of Health (SDOH) are the conditions and circumstances in which people are born, grow, live, work, and age that affect their overall health and well-being.

These determinants can include factors such as:

SDOH conditions and Z codes can be added to a patient via the Clinical Data tab's ‘+ Add condition’ blue function.

When a user clicks the link, a type-ahead dropdown field will populate where the user can begin to search for the necessary SDoH condition(s).

To attach a Z-code to a selected condition, users can select ‘+ Add from Diagnosis History’ next to the existing condition and then select a Z-code from the drop-down menu.

ThoroughCare will provide the most commonly used Z-codes for that condition, but users can always add a new Z-code by selecting ‘Add New’ from the drop-down menu.

Once an SDOH condition and/or Z-code have been added, both will be displayed in the conditions table.

NOTE: SDOH conditions will not be displayed on a problem index card under the Care Management tab or in the Summary of Care tab.

NOTE: When claims are generated, the top 4 conditions assigned to a program listed in the Clinical Data tab will be those that are submitted to billing and claims. To rearrange the order of these conditions, users can utilize the arrows next to each condition to then drag and drop the conditions into a new order.

SDOH conditions and Z-codes can also be added to a patient’s listed conditions via the Care Management tab.

First users will navigate to the Care Management tab on the patient landing page. From there, select ‘View All’ under ‘Conditions Information’.

The ‘Edit Patient Conditions’ modal will then be displayed. Users can select ‘+ Add condition’ and follow the same process as mentioned above.

PCM users should note that linking an SDOH condition and Z-code to a program such as Chronic Care Management (CCM) will then qualify the patient to be managed as a CCM patient and the patient’s billing and claims information will then update accordingly.

To add a SDOH condition and Z-code for a patient that users wish to continue managing through PCM, no linked program should be assigned.

To view all conditions assigned to a patient, including those not linked to a program, users can navigate to the Clinical Data tab under ‘Conditions.”

All conditions assigned to a patient can also be viewed from the Care Management Tab by selecting “View all” under Conditions Information.

Users can utilize the drop-down menu in the upper right corner of the ‘Edit Patient Conditions’ modal and then select ‘Show All Programs’.

Users can then view conditions regardless of assigned linked programs.

To assist users and remove manual effort from documenting SDoH conditions, ThoroughCare offers z-code automation through the HRSN and the HRSN-section of the Annual Wellness Visit's HRA. Once an HRSN is completed, all applicable Z-codes will be automatically included in the patient's 'Diagnosis History'.

Note: These automated codes will not automatically create or attach to any patient conditions. If a user would like to proceed with linking the Z-codes to an SDoH condition, they can follow the steps above.

Please see the table below for details on when an automated Z-code will be triggered:

To access other helpful ThoroughCare articles in the Knowledge Base or to get help from the ThoroughCare Support team members, click the ‘i’ icon in the top right corner of the software next to the username and use the appropriate link!