Effective April 1, 2023, NC Medicaid is updating its guidance around billable codes for social drivers of health.
In September 2022, NC Medicaid implemented a new set of billable HCPCS codes (G codes) and ICD-10 diagnosis (Z codes) to capture actions that primary care providers take to address food and housing-related needs for their Medicaid members.
An update to the ICD-10-CM replaces Z59.1 (Inadequate Housing) with a set of more specific codes. As of April 1, 2023, NC Medicaid expects providers to use Z59.10 (Inadequate Housing, Unspecified) in place of Z59.1. This code should be used if a member responds “Yes” to the question “Are you worried about losing your housing?”
Original guidance on the HCPCS and ICD-10 codes used for social drivers of health can be found in the May 20, 2022, Medicaid bulletin New Billing Codes for Social Drivers of Health.
Contact
NC Medicaid Contact Center, 888-245-0179