What Are ICD-10 Codes?
ICD-10 codes are a list of diagnostic codes created by the International Classification of Diseases. The list includes diseases, symptoms, abnormal findings, complaints, and causes of injuries or diseases. Health care providers and hospitals now have new human trafficking diagnostic codes to help them differentiate patients who have experienced human trafficking from patients who have experienced other forms of abuse. In 2018, the Centers for Disease Control added these new data collection codes to report cases of forced labor, sexual exploitation, and human trafficking victimization.
Why Are ICD-10 Codes Important to Human Trafficking?
ICD-10 codes are important to human trafficking because when these codes are added to a patient’s electronic health record, health care providers can use these codes to track and improve patient care. Providers can use a combination of ICD-10 codes to more fully show how trafficking affects physical and mental health, for example:
- S/T codes: injury, poisoning, or consequences of other external causes
- Z codes: factors that influence health such as social determinants of health
Using ICD-10 codes helps providers (1) gain a full picture of the patient’s circumstances and (2) respond to patients in a person-centered, trauma-informed, and multidisciplinary way. In addition, using ICD-10 codes to track medical conditions related to trafficking can help create policies and resource allocation.
Where to Be Cautious?
Confidential patient information in the electronic health record, including ICD codes for human trafficking, could threaten patient privacy and safety. Providers who are not trained in human trafficking may unintentionally harm patients when they use a diagnostic code for trafficking but do not educate the patient about trafficking and how often it occurs. On the other hand, using ICD codes for trafficking could actually validate and normalize the extent to which trafficking occurs, which could help reduce the stigma often associated with a trafficking diagnosis. Here are some ways health professionals and administrators can protect patient privacy and confidentiality:
- Take steps to keep electronic health records secure.
- Create and enforce policies that protect data.
- Train staff on how to manage confidential information.
- Help providers and patients communicate with each other about how information is recorded in the electronic health record and who is allowed to read it.
Rolling Out ICD Codes: Tips and Strategies
- Create a human trafficking response plan.
- Train health care providers on labor and sex trafficking and how to respond to suspected trafficking.
- Train all professionals who create or read medical records about confidentiality policies and practices.
- Train physicians, other health care providers, and coders on (1) the new human trafficking ICD codes and (2) the organization’s policy on how confidential information is concealed in the electronic health record.
- Train physicians on how to inform patients about the confidentiality measures included in the electronic health record and how ICD codes are used.
- Follow a zero-tolerance policy for staff bias or discrimination against patients.
- Use an electronic health record system that allows differential access to confidential information.
- American Hospital Association. (n.d.). ICD-10-CM coding for human trafficking: AHA. Retrieved April 3, 2020, from https://www.aha.org/icd-10-cm-coding-human-trafficking-resources
- Greenbaum J., & Stoklosa, H. (2019). The healthcare response to human trafficking: A need for globally harmonized ICD codes. PLOS Medicine, 16(5), e1002799. https://doi.org/10.1371/journal.pmed.1002799
- HEAL Trafficking & International Centre for Missing and Exploited Children. (2021). Documenting ICD codes and other sensitive information in electronic health records: Guidelines for healthcare professionals who encounter patients with a history of human trafficking or other forms of violence. https://cdn.icmec.org/wp-content/uploads/2021/02/Final-ICD-code-documentation-recommendations-Feb-2021.pdf
- Macias-Konstantopoulos, W.L. (2018). Diagnosis codes for human trafficking can help assess incidence, risk factors, and comorbid illness and injury. AMA Journal of Ethics, 20(12). doi: 10.1001/amajethics.2018.1143. https://journalofethics.ama-assn.org/article/diagnosis-codes-human-trafficking-can-help-assess-incidence-risk-factors-and-comorbid-illness-and/2018-12
- Office on Trafficking in Persons. (2018). CDC adds new human trafficking data collection fields for health care providers. https://s3.amazonaws.com/media.guidebook.com/upload/146358/N5Vl2i5gPNa96vk1smcptUADDbuOjEJhZ9MA.pdf