For the first time, 29 new ICD-10 codes will be available on Oct. 1 to allow providers to identify and assist victims of human trafficking and coding professionals to translate that information into data that will provide greater insights into the problem. 

The AHA’s Hospitals Against Violence (HAV) initiative, in collaboration with Catholic Health Initiatives and Massachusetts General Hospital’s Human Trafficking Initiative and Freedom Clinic, along with support from other hospital and health system members, advocated successfully for the codes. Working together, the focus is now to educate providers, clinicians, coding professionals and others in the hospital likely to encounter victims on this important issue, including through a new webpage with dedicated resources on this topic. 

“Hospitals can and must take a leadership role in identifying victims and raising awareness about the issue,” said Wendy Macias-Konstantopoulos, M.D., director of MGH’s Human Trafficking Initiative. “These new codes will strengthen data collection on the health and social outcomes of human trafficking and inform the development of resources and services better equipped to respond to the profound trauma associated with this underreported, abhorrent crime.’’

Securing the Codes

For more than a year, AHA along with CHI and MGH worked to develop and then secure recognition for diagnostic codes that will allow health and medical professionals, as well as those they work with, to identify victims of human trafficking they encounter when they seek health care. 

The Centers for Disease Control and Prevention’s National Center for Health Statistics released the 29 ICD-10 codes in June. These codes will take effect Oct. 1. 

“The partnership with AHA and MGH on this human trafficking initiative was a positive and engaging collaboration, and I think that really helped push this forward,” said Colleen Scanlon, senior vice president and chief advocacy officer for Englewood, CO-based CHI. “We spent a lot of time considering different perspectives and expertise – clinical, coding, and violence prevention. The partnership which created the proposed codes and resulted in a successful outcome was a huge step forward for the health care community.” 

Educating Providers on Human Trafficking, New ICD-10 Codes

The International Labour Organization estimates that human trafficking is a $150 billion industry worldwide, with approximately 21 million victims. In the U.S., the National Human Trafficking Resource Center says more than 7,500 cases of human trafficking were reported in 2016, with activity occurring in all 50 states. 

While hospitals and health systems are in a unique position to identify and assist potential victims as they may seek treatment for occupational injuries, sexually-transmitted diseases or other chronic illnesses, many care providers are not trained in what to look for in identifying human trafficking, according to Holly Austin Gibbs, the human trafficking response program director at San Francisco-based Dignity Health. 

“Whether we are prepared to support a victim or not, they are going to come into our health care systems,” said Gibbs, a survivor of child sex trafficking. 

Gibbs has hosted a number of webinars as part of the AHA’s HAV initiative to share information on how recognize and respond to victims of human trafficking. She said the ICD-10 codes are an important first step toward collecting good data, and “physician education is incredibly important accompanying implementation of the codes.” (Dignity Health’s educational resources include: Dispelling the Myths, A Trauma-Informed Health Care Response, and Creating a Human Trafficking Victim Medical Safe Haven in Resident Physician Education.)  MGH’s Macias-Konstantopoulos agrees that providing educating on the new ICD-10 codes is critical. 

“We need to expand standardized education and training across the specialties, so providers understand this form of interpersonal abuse and know these codes are available for use in their documentation,” she said. “Once providers start consistently looking for human trafficking and using the codes when appropriate, I think the codes will be invaluable.” The new codes will not be able to capture data for survivors who don’t seek medical care, but “it will give us a sense of the scope of the problem, how widespread it is, and what illnesses and injuries are associated with human trafficking,” Macias-Konstantopoulos said. She hopes that this data can help inform health policy and resource allocation for intervention and prevention efforts. Nelly Leon-Chisen, AHA’s director of coding and classification, stressed the importance for coding professionals to receive education on the new codes, saying it is “crucially important for coding professionals to understand how to recognize and use these codes.” The new AHA webpage has both a factsheet and a video to help these professionals better understand the codes and how to use them. 

The AHA webpage has a plethora of other resources for identifying and assisting victims of human trafficking, including tools related to the new ICD-10 codes and videos in which Katherine Chon, the founding director of the Office on Trafficking in Persons (OTIP) within the Administration for Children and Families at the U.S. Department of Health and Human Services, describes the trove of free resources its website has to help increase awareness of the issue and connect health care providers with the services they need. More resources will be added leading up to Oct. 1. 

Other Resources to Combat Violence

In 2016, under the leadership of the AHA Board of Trustees, AHA developed the Hospitals Against Violence initiative to shine a light on how hospitals and health systems are working to heal victims of violence and their communities, as well as prevent further acts of violence. Hospitals and health systems are partnering with community groups to address violence in its many forms. The HAV initiative shares examples and best practices with the field, with a particular emphasis on youth violence prevention, workplace violence prevention, combatting human trafficking and other programs. Organizations with resources to share may submit materials to hospitalsagainstviolence@aha.org.

“Violence – in all its forms – impacts health and well-being,” says CHI’s Scanlon. “AHA’s leadership in the Hospitals Against Violence initiative really brings greater attention to and focus on violence as a health issue and the important role that hospitals, health care entities, and provider communities can have in preventing and mitigating violence.” 

For more on the Hospitals Against Violence initiative, visit https://www.aha.org/preventviolence.