Hurricanes Prompt Urgent Focus on Documenting Social Determinants of Health: Part I

EDITOR’S NOTE: This is the first in a two-part series on the coding and documenting of social determinants of health (SdoH). It comes on the heels of the aftermath of Hurricanes Harvey and Irma and their impact on victims and survivors in the flood-ravaged cities of Texas and Florida.

Hurricanes Harvey and Irma provide good illustrations of how important it is to document and code the social determinants of health (SDoH). There are multiple predictive models using demographic (U.S. Census), social, and economic data. In healthcare, data is collected either from the financial databases (for which ICD-10 data is key) or from more labor-intensive methods such as chart review and other studies.

There is unrealized potential for real-time data collection within the clinical documentation integrity (CDI) and medical coding communities. In these days and weeks ahead, coinciding with the post-disaster recovery efforts in both Texas and Florida, it is very important that healthcare professionals capture this information for several reasons. These include the following:

1. Data snapshots in time. In days gone by, journalists and photographers have documented wars and disasters, which has helped future generations learn from the past. In this generation, the added dimension of data has evolved. Clinical documentation integrity specialists (CDISs) and medical coders need to make sure that SDoH information gets into data so that this information will be of value for future generations. Consider, for example, the following:
Problems related to other psychosocial circumstances: Z65.5, Exposure to disaster, war and other hostilities; Z64.4, Victim of crime and terrorism (if the patient is a victim of looting;

Employment: Many will be either temporarily unemployed (Z56.0), have to change jobs (Z56.1), or be under threat of job loss (Z56.2) as businesses are impacted. They may experience physical and mental strain related to work (Z56.8). They may be militarily deployed to assist (Z56.82);
Occupation: They may be exposed to toxic agents, as in the case of the area where explosions shook a flooded chemical plant near Houston last week (Z57.5);
Problems related to housing and economic circumstances: Lack of adequate food and safe drinking water (Z59.4); insufficient social insurance and welfare support (Z59.7);

Other problems related to primary support group, including family circumstances (Z63): Absence of a family member due to military deployment (Z63.31) as military first responders are called up; Disappearance and death of family member (Z63.4) as patients present to health systems with anxiety symptoms related to waiting for updates on their family members status; dependent relative needing care at home (Z63.6), which can either be a chronic issue or temporary, as families are displaced. Social systems can be impacted as people respond to stress in different ways, which can include alcoholism and drug addiction in the family (Z63.72)
 
  1. This data is reflective of an untapped real-time ability to connect actual health issues with SDoH so that healthcare systems can prepare more for future disasters going forward.
  2. Traditionally, only physical manifestations of disaster have been acknowledged. But there currently exists the opportunity to link the additional layers of SDoH. If the patient’s psychological effects are also identified in the chart, it can be of great use as well. For example, in the past if patient presented to the ER after sustaining a laceration as a result disaster, the link would be made; however, the link to the SDoH is less clear when patients present to the ER for non-cardiac chest pain or shortness of breath, which may be a result of anxiety. Statisticians may find meaningful inference from the SDoH. 

Now, during hurricane season and its aftermath, would be a very critical time in data capture that can help allocate healthcare resources more appropriately going forward.

Facebook
Twitter
LinkedIn

Related Stories

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

Mastering OB GYN Coding Accuracy: Precision Coding for Compliance and Reimbursement

Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Sherri L. Clayton, RHIT, CSS. You’ll learn how to apply global maternity package rules accurately, select the right CPT codes for procedures and visits, and identify documentation gaps that lead to denials. With practical guidance and real examples, this session helps you strengthen compliance, reduce audit risk, and ensure accurate reimbursement for women’s health services.

May 14, 2026

2026 ICD-10-CM/PCS Coding Clinic Update Webcast Series

Uncover essential coding insights with nationally recognized coding authority Kay Piper, RHIA, CDIP, CCS. Through ICD10monitor’s interactive, on‑demand webcast series, Kay walks you through the AHA’s 2026 ICD‑10‑CM/PCS Quarterly Coding Clinics, translating each update into practical, easy‑to‑apply guidance designed to sharpen precision, ensure compliance, and strengthen day‑to‑day decision‑making. Available shortly after each official release.

April 13, 2026

2026 ICD-10-CM/PCS Coding Clinic Update: Fourth Quarter

Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s fourth quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.

December 14, 2026

2026 ICD-10-CM/PCS Coding Clinic Update: Third Quarter

Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s third quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.

October 12, 2026

Trending News

Featured Webcasts

Reengineering Utilization Management: Building an Adaptive Model for the New Payer Era

Traditional utilization management models can no longer keep pace with regulatory shifts, payer scrutiny, and operational pressures. In this webcast, Tiffany Ferguson, LMSW, CMAC, ACM, ACPA-C, introduces an Adaptive Model strategy that modernizes UM through role specialization, technology-driven workflows, and proactive, team-based processes. Attendees will learn how to restructure programs to improve efficiency, strengthen clinical collaboration, and enhance financial performance in a rapidly changing healthcare environment.

May 20, 2026

Compliance for the Inpatient Psychiatric Facility (IPF-PPS): Minimizing Federal Audit Findings by Strengthening Best Practices

Federal auditors are intensifying their focus on inpatient psychiatric facilities, using advanced data analytics to spotlight outliers and pursue high‑dollar repayments. In this high‑impact webcast, Michael Calahan, PA, MBA, Compliance Officer and V.P., Hospital & Physician Compliance, breaks down what regulators are really targeting in IPF-PPS admissions, documentation, treatment and discharge planning. Attendees will learn practical steps to tighten processes, avoid common audit triggers and protect reimbursement and reduce the risk of multimillion-dollar repayment demands.

April 9, 2026

Mastering MDM for Accurate Professional Fee Coding

In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.

March 31, 2026

The PEPPER Returns – Risk and Opportunity at Your Fingertips

Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.

March 19, 2026

Trending News

Happy HIP Week! Sign up to win free access to our 2026 Coding Clinic Update Webcast Series! Click here to learn more →

Prepare for the 2025 CMS IPPS Final Rule with ICD10monitor’s IPPSPalooza! Click HERE to learn more

Get 15% OFF on all educational webcasts at ICD10monitor with code JULYFOURTH24 until July 4, 2024—start learning today!

BLOOM INTO SAVINGS! Get 25% OFF during our spring sale through March 27. Use code SPRING26 at checkout to claim this offer.

CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25

CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24