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.
- 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)
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:
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.
Download the complete tip, Homelessness.