Skip to Main Content

Code Awareness and Z Code Billing

Date: 02/27/26

Z-Code Awareness

Arizona Complete Health integrates health equity into all aspects of care, ensuring every individual has fair opportunities to achieve optimal health and independence. By focusing on Drivers of Health (DOH) as part of Whole Person Care, AzCH delivers culturally responsive, effective services that address social factors impacting health outcomes. Screening for Drivers of Health (DOH) risk factors and documenting Z-codes helps close care gaps, reduce crises, and improve resilience across communities.

Call to Action

Providers must document Z-codes at every opportunity to ensure members receive the right support at the right time.

What Are Z-codes

Why Z-codes in Whole Person Care (WPC) Matter

Z-codes are special ICD-10 codes that document a person’s social needs, life circumstances, and other non-medical factors that affect health.

 

They capture things like housing challenges, food insecurity, transportation barriers, financial strain, or safety concerns.

 

By documenting Z-codes, providers help ensure whole-person care by making these important drivers of health visible in the medical record so members can be connected to the right supports and services.

Z-codes matter in WPC because they make members’ social needs visible in the care process.

 

By documenting Z-codes, providers can improve care coordination, quality of care, and cultural responsiveness, quickly identify unmet needs, and ensure members are connected to the right referrals and community resources.

 

Z-codes also strengthen equity reporting and population health insights by giving organizations a clearer picture of the social and environmental factors affecting health across the communities they serve.

Examples of Common Z-codes

When and How to Document Z-codes

  •  Z59.81 – Housing instability, housed
  •  Z59.41 – Food insecurity
  •  Z59.82 – Transportation insecurity (includes lack of transportation, unaffordable, unreliable, or unsafe transportation)
  •  Z59.86 – Financial insecurity, financial strain
  •  Z65.3 – Problems related to other legal circumstances
  •  Z55.0 – illiteracy and low-level literacy

Document Z-codes whenever a member shares a social need, barrier, or life circumstance that affects their health or ability to receive care. Z-codes should be used even when no referral is made, as they help capture important context in the medical record.

 

All providers can document Z-codes and participate in established screening and documentation workflows to ensure accurate and complete reporting.

What Happens After Documentation

Why it Matters for Your Organization

After a Z-code is documented, it helps trigger referrals or care coordination so members can be connected to the right supports.

 

This documentation supports closed-loop referral, ensuring needs are addressed and outcomes are tracked.

 

Z-codes improve visibility into community needs by highlighting patterns and barriers affecting a member’s health.

Documenting Z-codes matters to your organization, because it reinforces your organization’s commitment to whole-person care by making members’ social needs visible in the care process.

 

High-quality Z-code data supports compliance with whole-person care and cultural competency requirements while strengthening planning and reporting by providing a clearer picture of community needs and aligning your organization with Medicaid and health plan standards for accurate, equity-focused documentation.

 

Resources:

For questions or assistance on use of Z-Codes, please contact AzCHCulturalAffairs@azcompletehealth.com.

Billing Z-Codes

Many of you are now regularly billing Social Determinants of Health diagnoses codes. THANK YOU!

Social Determinants of Health (SDOH) are the conditions in which people are born, grow, live, work, and age. These circumstances are shaped by the distribution of money, power, and resources, at the global, national, and local levels. These are the broader social conditions and non-medical factors that influence health outcomes, such as income, education, housing, and working conditions. While health related social needs (HRSN) are social and economic factors that can negatively impact a person's health and well-being. These include needs such as employment, affordable and stable housing, healthy food, personal safety, transportation, and affordable utilities. These are more intimate, non-medical, and immediate needs impacted by the broader conditions that can affect a person's health and well-being.

AHCCCS began monitoring for the presence of Social Determinants of Health ICD-10 codes (z-codes) on April 1, 2018 and to require that providers submit identified Social Determinant of Health ICD-10 diagnosis codes on Medicaid claims in order to comply with state and federal coding requirements.

Z codes are a set of diagnostic codes used in the International Classification of Diseases, 10th Revision (ICD-10) to document social risk factors influencing health status.

AzCH promotes the use of SDOH ICD-10 codes on claims to support data collection on the social risk factors of health experienced by members. To learn more, visit:

AHCCCS has provided guidance that Social Determinants of Health codes are NOT to be used as primary ICD-10 diagnosis codes. Social Determinants of Health codes should instead be listed secondary, tertiary, etc., ICD-10 codes.

For more information on Social Determinants of Health please refer to the following resources on the AHCCCS website:

Thank you for following the AHCCCS guidance and requirement regarding submission of these very important codes. We appreciate everything you do to care for our members.

If you have questions regarding the information contained in this update, please contact our Whole Person Care Specialist at azchculturalaffairs@azcompletehealth.com