On October 1, clinicians and coding professionals should begin using new ICD-10 CM codes specific to human trafficking. The 29 new codes were released this summer by the Centers for Disease Control and Prevention’s National Center for Health Statistics. AHA’s Central Office on ICD-10, which publishes Coding Clinic, proposed the change in collaboration with Catholic Health Initiatives and Massachusetts General Hospital's Human Trafficking Initiative and Freedom Clinic, along with the support of other member health systems. Nelly Leon-Chisen, director of coding and classification at the AHA, below shares how organizations can most effectively use the new codes. For more, see the related video.

Q: Why is human trafficking relevant for ICD-10 CM codes?
A: Human trafficking is a public health concern, and criminal act, that hospitals and health systems see every day. These new ICD-10 CM codes support the appropriate treatment and track these occurrences in our communities – and that will ultimately help us stop the cycle of human trafficking.

Q: How should coding professionals and clinicians apply the new codes?
A: Urged by the AHA’s Hospitals Against Violence initiative, Catholic Health Initiatives and Massachusetts General Hospital’s Human Trafficking Initiative and Freedom Clinic, new codes were released in June 2018 and are effective fiscal year 2019. These include data collection on adult or child forced labor or sexual exploitation, either confirmed or suspected. Codes may be assigned in addition to other existing ICD-10-CM codes for abuse, neglect or other maltreatment. 

In addition, new codes also are available for past history of sexual or labor exploitation, encounter for examination and observation of exploitation ruled out, and an external cause code to identify multiple, repeated, perpetrators of maltreatment and neglect. (For a complete list of new codes, see AHA’s factsheet.)

Q: What three actions can clinicians and coding professionals take today to prepare for the Oct. 1 start date?

1. Both coding professionals and clinicians should review a patient’s medical record to identify the appropriate ICD-10-CM codes to include. They should be aware of and begin utilizing codes for forced sexual exploitation and forced labor exploitation.

2. Help educate colleagues on the need to collect data on forced labor or sexual exploitation of individuals. Find free resources to educate your staff and community about human trafficking, as well as how providers can help victims of human trafficking, at aha.org.

3. On Oct. 1, begin using the new codes to help create another source of essential data collection to inform public policies and prevention efforts, as well as support the systemic development of an infrastructure for services and resources.

Q: How can clinicians connect coding with identification and assisting victims of human trafficking?
A: Coding professionals and clinical leaders can join together to educate staff that new codes exist, so teams can work together to help victims and also better measure how human trafficking is impacting our communities. The AHA’s Hospitals Against Violence webpage has a number of tools and resources on human trafficking, as well as information on new ICD-10 CM codes, including key terms that may be used in medical documentation.

Visit https://www.aha.org/combating-human-trafficking for more on combatting human trafficking.

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