Codifying social determinants of health: a Gap in the ICD-10-CM

If you have ever found yourself experiencing R45.4 (irritability and anger) in response to scrolling through endless rows of diagnosis codes, you are not alone: navigating medical billing and coding can be equal parts frustrating and mystifying. The sheer number of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis codes—which approaches 70,000 as of the tenth revision—can feel overwhelming. Some codes, like V91.07 (burn due to water-skis on fire), are so absurdly specific it is hard to imagine them ever being used in clinical practice. Meanwhile, social determinants of health (SDOH), which are major contributors to quality of life and disparities in health outcomes, are glaringly underrepresented in this plethoric catalog.