In the last month, I have used the ICD-10 codes Z59.0 (homelessness), Z59.1 (inadequate housing) and Z59.9 (unspecified housing or economic problem) far more than I ever would have imagined. Several patients came into my urban clinic with varied chief complaints, including issues with uncontrolled asthma, chest pain, stress, worsening knee pain and sciatica. However, after listening and asking questions, I quickly realized that all of these initial complaints shared a commonality — distress about housing.
My first patient had recently left transitional veteran housing provided by Volunteers of America to get his own permanent housing elsewhere. However, he soon realized the housing conditions at his former residence were much better than the rodent-, cockroach- and mold-infested single-room occupancy he had been granted by the local housing authority. His new residence also featured a caved-in roof.
During his visit with me, he requested adjustments to his asthma medications. The numerous triggers he encountered at his new address had already led to an emergency department visit earlier in the month. He asked me to write a letter to the housing authority, communicating the severe consequences the poor environment was having on his health. I learned then that inadequate housing is a billable diagnosis if there is lack of heating, restriction of space, technical defects in the home preventing adequate care, or unsatisfactory surroundings.
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