DataPoint: 2017 Z Code Utilization

In 2017, the unique beneficiary count for Z code utilization was 467,136, representing a 4.7 percent increase since 2016, based on a study of Medicare claims and enrollment data obtained from the Centers for Medicare and Medicaid Services (CMS) Chronic Condition Data Warehouse (CCW). Medicare fee-for-service (FFS) Z code utilization represented 1.4 percent of total beneficiaries in 2017. Z codes, which are a subset of ICD-10-CM codes, identify social determinants of health (SDOH). SDOH include conditions of an individual's living, learning, and working environments that affect their health risks and outcomes and are applicable in all health care settings. The top three most utilized Z codes were homelessness, problems related to living alone, and disappearance and death of a family member. Of the 467,136 Medicare FFS beneficiaries with Z code claims in 2017, 334,373 (72 percent) had hypertension, and 248,726 (53 percent) had depression. Additionally, 117,478 (25 percent) Medicare FFS beneficiaries with Z code claims were dual eligible, and 281,517 (60 percent) were female. Of the 33.7 million total Medicare FFS beneficiaries in 2017, 4.4 million (13 percent) were age 85 and older.

To view the entire CMS report, click here.

Contact: Ken Allison, kallison@leadingageny.org, 518-867-8820