Human Trafficking: New ICD-10 Codes Empower Efforts to Identify and Aid Victims

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Original story posted on: September 24, 2018

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New ICD-10 codes that address human trafficking become effective Oct. 1.

This year has seen the launch of the ICD-10 Z codes, and now we will also have T codes to address human trafficking. Catholic Health Initiatives (CHI) has collaborated with several healthcare organizations , including the American Hospital Association's Hospitals Against Violence initiative and clinicians at the Boston-based Massachusetts General Hospital's Freedom Clinic, to develop the codes.

Published by the Centers for Disease Control and Prevention (CDC) last June, the codes will take effect in October. The 29 new ICD-10 codes were developed over an 18-month period and are expected to leverage the ability of providers to document clients who might be at risk of sex and labor exploitation. Over 40,000 cases of human trafficking have been reported to the National Human Trafficking Resource Center (NHTRC) between 2007 and 2017, with these numbers continuing to rise. The Polaris Project identifies more than 40.3 million victims of human trafficking globally, including:

  • 81 percent trapped in forced labor.
  • 25 percent being children.
  • 75 percent being women and girls.

Of particular concern are the profound health and behavioral health manifestations that mandate attention by practitioners, plus lost opportunities to identify and aid victims. Hospitals play a critical role in assessing, identifying, and assisting victims of human trafficking. Eighty-eight percent of sex trafficking survivors have reported contact with a healthcare provider while they were being exploited. The most frequent site referenced in the NHTRC report was the hospital emergency department. Victims may seek treatment for a host of acute and chronic injuries, including:

  • Violence-related injuries
  • Sexually transmitted diseases
  • Pregnancy
  • HIV/AIDS

Documentation of what health professionals observe in these situations is critical to confirming whether a victim is being trafficked. Similar to the new Z codes that account for social determinants of health (SDoH), use of the T codes, as well as several Y and Z codes, will rely heavily on both clinical and non-clinical indicators to validate the circumstances. Human trafficking situations can easily strike at the clinical gut of practitioners, evoking a strong reaction, at times because something just feels “off” to those members of the treatment team involved in the assessment. It may be that a physical injury is inconsistent with the report, or it could involve how the victim is accompanied by someone who does not allow him or her to speak to the practitioner alone, if at all.
To ramp up awareness of the new ICD-10 codes, the American Hospital Association (AHA) has provided the content on its Hospitals Against Violence website, which now includes distinct guidance and resources on:

  • Combatting human trafficking
  • Workplace violence prevention
  • Youth violence prevention
  • Hospitals Against Violence (HAV) national initiative

These codes include the following:
 
T74.51 Adult forced sexual exploitation, confirmed
T74.52 Child sexual exploitation, confirmed
T74.61 Adult forced labor exploitation, confirmed
T74.62 Child forced labor exploitation, confirmed
T76.51 Adult forced sexual exploitation, suspected
T76.52 Child sexual exploitation, suspected
T76.61 Adult forced labor exploitation, suspected
T76.62* Child forced labor exploitation, suspected
Y07.6 Multiple perpetrators of maltreatment and neglect
Z04.81 Encounter for examination and observation of victim following forced sexual exploitation
Z04.82 Encounter for examination and observation of victim following forced labor exploitation
Z62.813 Personal history of forced labor or sexual exploitation in childhood
Z91.42 Personal history of forced labor or sexual exploitation

Also included on the AHA website are:

  • A human trafficking FAQ sheet on the new codes
  • 10 red flags, geared to educate practitioners on what to look for in determining if a patient is a victim of trafficking
  • Additional links to local and federal resources


The new codes will serve as the official diagnoses used to describe diseases, causes of diseases, and deaths related to human trafficking.



Program Note:

Listen to the AHA’s Nelly Leon-Chisen report on these new codes during Talk Ten Tuesday, Oct. 2, 10-10:30 p.m. ET.


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Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP

Ellen Fink-Samnick is an award-winning industry expert who empowers healthcare’s transdisciplinary workforce through professional speaking, writing, mentoring, and consultation. Known as “The Ethical Compass of Professional Case Management,” Ellen is an esteemed author with more than 100 publications to her credit. She has developed content for many of the industry’s knowledge projects for case managers, including books, chapters, articles, and continuing education on the ethical use of technology, competency-based case management, collaborative care, the Social Determinants of Health, and dimensions of workplace bullying. Her contributions to professional case management, ethics, and clinical social work transverse professional associations and credentialing organizations.

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