ICD10monitor April 22, 2024
Tiffany Ferguson, LMSW, CMAC, ACM

In its Inpatient Prospective Payment System (IPPS) Proposed Rule for the 2025 fiscal year (FY), the Centers for Medicare & Medicaid Services (CMS) is considering a change in the severity level designation for the social determinants of health (SDoH) diagnosis codes denoting inadequate housing and housing instability from non-complication or comorbidity (Non-CC) to complication or comorbidity (CC).

Consistent with the annual updates to account for changes in resource consumption, treatment patterns, and the clinical characteristics of patients, CMS is recognizing inadequate housing and housing instability as indicators of increased resource utilization in the acute inpatient hospital setting.

“Inadequate housing” is defined as an occupied housing unit that has moderate or severe

physical problems, such as plumbing, heating, electricity, or upkeep...

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