CMS has determined the average costs associated with homeless patients are greater compared to patients with similar diagnoses who are not homeless. Consequently, homelessness will be classified as a comorbidity (CC) within the MS-DRG reimbursement methodology, which can increase reimbursement.
Providers should include the patient’s housing situation within their documentation as appropriate. Homelessness is defined as, “Because of economic difficulties, currently living in a shelter, motel, temporary or transitional living situation, scattered site housing, not having a consistent place to sleep at night, or sleeping in a place not meant for human habitation.”
The diagnosis codes for homelessness are classified as social determinants of health (SDOH). ICD-10-CM includes the following codes to capture homelessness:
- Z59.00 Homelessness, unspecified
- Z59.01 Sheltered homelessness
- Due to economic difficulties, currently living in a shelter, motel, temporary or transitional living situation, scattered site housing, or not having a consistent place to sleep at night
- Z59.02 Unsheltered homelessness
- Residing in a place not meant for human habitation, such as cars, parks, sidewalks, or abandoned buildings (on the street)
Although these codes can be reported based on the documentation of non-providers, such as case managers, these notes are unlikely to be easily accessible to the inpatient coder.
