New ICD-10 codes address human exploitation

September 26th, 2018 / By Rebecca Caux-Harry

Today, while reading an article about some upcoming new ICD-10 codes, my mind drifted to the part of the world population at risk for exploitation.  In response to increasing violence and the impact on public health, the American Hospital Association (AHA) created the Hospitals Against Violence Initiative in 2016. Additionally, they have a website dedicated to detecting and reporting on victims of human trafficking, adult or child forced labor or sexual exploitation.  The focus of this initiative, in partnership with Catholic Health Initiatives and Massachusetts General Hospital, has resulted in more specific ICD-10 codes that will become effective on Oct. 1, 2018.

We have 29 new ICD-10 codes, most of which have been added to Chapter 19, under “T74: Adult and child abuse, neglect and other maltreatment, confirmed.”  Be aware, however, that some of the new codes include “suspected” in the descriptor.  The new codes in this section include:

               T74.51X*             Adult forced sexual exploitation, confirmed

               T74.52X*             Child sexual exploitation, confirmed

               T74.61X*             Adult forced labor exploitation, confirmed

               T74.62X*             Child forced labor exploitation, confirmed

               T76.51X*             Adult forced sexual exploitation, suspected

               T76.52X*             Child sexual exploitation, suspected

               T76.61X*             Adult forced labor exploitation, suspected

               T76.62X*             Child forced labor exploitation, suspected

*Use the appropriate 7th character:

               A             Initial encounter

               D            Subsequent encounter

               S             Sequela

Additional codes available are in Chapters 20 and 21:

               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

The purpose of these codes is to facilitate the tracking of needs for exploited people.  Because healthcare providers can have very private encounters with patients, they are often able to detect people suspected or confirmed of being victims of trafficking.  According to the AHA, very few victims will self-identify, so providers (especially those in behavioral health) become key in identifying those patients in need of resources and support.  As coders, we can only code language that is present in the medical document, so educate all the providers about documentation of suspected or confirmed exploitation as well as the availability of these new codes.  The previously mentioned website contains fact sheets, tool kits, webinars and educational videos about detecting human trafficking and language to look for in the record to support appropriate coding.  The audience can be administrators, nurses and physicians, or clerical staff. 

Rebecca Caux-Harry, CPC, is the CodeRyte product specialist for cardiology with 3M Health Information Systems.