The Medicare Annual Wellness Visit (AWV) offers a critical opportunity to assess not only a patient’s medical history and preventive care needs but also their social circumstances. One powerful—but often underutilized—tool for capturing this broader view of patient health is the ICD-10-CM Z codes.
Z codes are diagnostic codes used to document social, behavioral, and environmental factors that affect health. While they are not typically tied to payment directly, they are essential for risk adjustment, quality reporting, and supporting value-based care initiatives.
This post highlights the most popular and relevant Z codes for Medicare AWVs—and how your practice can use them effectively.
Most importantly, Z codes enable primary care providers to capture the real-life barriers that may impact a senior’s health—especially around Social Determinants of Health (SDOH).
Here’s a list of high-yield Z codes frequently used during AWVs, grouped by category:
These codes are especially relevant if you're billing G0136 (SDOH risk assessment) with your AWV.
Isolation is a major risk factor for depression and cognitive decline—important to address during AWVs.
If patients struggle with understanding health instructions, these codes may be relevant and justify longer education time or care management referrals.
For younger Medicare beneficiaries (e.g., due to disability), these codes are relevant to understanding financial or psychological stressors.
These can help explain the context behind mental health screenings or behavioral health referrals initiated during AWVs.
Use standardized tools during the AWV, such as:
These tools align with G0136 billing and naturally produce documentation that supports Z code use.
Z codes are a simple but powerful way to document what’s often invisible in the EHR: the social realities affecting your patients’ health. When used correctly during a Medicare Annual Wellness Visit, they support comprehensive care and give your team the data needed to act on what matters most.
While they don’t always drive immediate reimbursement, they strengthen your practice’s alignment with value-based care, quality initiatives, and health equity efforts.
