Learn to Code: Human Trafficking

3 min read

Did you know? January is Human Trafficking Prevention Month, and January 11th is National Human Trafficking Awareness Day. Read more to learn about human trafficking and how it is classified in ICD-10-CM.

The Department of Homeland Security launched the public awareness Blue Campaign to educate the public, law enforcement, and other industry partners to recognize the indicators of human trafficking. Human trafficking is a global public health concern and a crime. It occurs when a trafficker exploits an individual with force, fraud or coercion to make them perform commercial work or sex. It can happen in any community and its victims can be any age, race, gender, or nationality.  

The American Hospital Association (AHA) has many resources to help the medical field combat human trafficking, including a resource from 2018 that guided the field on how to code this type of abuse.  

The first ICD-10-CM codes classifying human trafficking abuse were released in June 2018. Before these codes were released, there was no way to differentiate victims of human trafficking from other victims of abuse. Additionally, there was no way for clinicians to classify a diagnosis adequately and plan for the resources to provide appropriate treatment. At this time, the United States is the only country to adopt diagnosis codes for human trafficking. Codes specific to human trafficking facilitate the gathering of more specific data, as child and adult abuse are both underreported and underdiagnosed. These codes also aid public health officials by helping them determine how often human trafficking occurs and define characteristics of this abuse. Using the clinical codes for human trafficking will ultimately inform ways to help victims of this abuse.  

Codes for human trafficking are found in chapter 19 of ICD-10-CM. The first axis of classification of abuse, neglect, or other maltreatment of a child or adult is whether the abuse is confirmed (category T74) or suspected (T76). The fourth character for categories T74 and T76 indicates the type of abuse, including a character specifically for forced sexual exploitation and forced labor exploitation.  

ICD-10-CM does not specify the age limit for the assignment of child abuse codes versus adult abuse codes, since the legal age of adulthood varies among states.  ICD-10-CM also classifies confirmed adult and child abuse as assault. Any of the assault codes (X92-Y09) may be used to indicate the external cause of any physical injury resulting from the confirmed abuse. In cases of confirmed abuse, use an additional External cause code to identify the perpetrator, if known (Y07.-).  

Human trafficking can result in physical injuries and other medical conditions. When this is the case, sequence first the appropriate code from categories T74 or T76, followed by codes for any associated diagnoses. Child or adult abuse should be coded before the associated injuries or conditions resulting from the abuse. There are also Z codes that can be assigned as additional diagnosis codes. Subcategory Z62.81, Personal history of abuse in childhood, provides codes to indicate that a patient has a past personal history of abuse in childhood; codes from subcategory Z91.4 indicate that a patient has a past personal history of adult psychological trauma. There are also counseling codes (category Z69) to provide information regarding encounters for mental health services for the victim or perpetrator of abuse.  

Finally, never interpret narrative descriptions as abuse without the physician’s confirmation. It is up to law enforcement to investigate suspected cases of human trafficking.  

Visit the Department of Homeland Security’s Blue Campaign website to learn more about human trafficking and how you can protect yourself and others.  

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Resources

1. Combating human trafficking: AHA. American Hospital Association. (n.d.-a). https://www.aha.org/combating-human-trafficking
2. ICD-10-CM coding for human trafficking. American Hospital Association. (n.d.). https://www.aha.org/system/files/2018-09/icd-10-code-human-trafficking.pdf  
3. Garg, A., Panda, P., Malay, S., & Slain, K. N. (2022). Human Trafficking ICD-10 Code Utilization in Pediatric Tertiary Care Centers Within the United States. Frontiers in pediatrics, 10, 818043. https://doi.org/10.3389/fped.2022.818043  
4. What is human trafficking?: Homeland security. U.S. Department of Homeland Security. (2022, September 22). https://www.dhs.gov/blue-campaign/what-human-trafficking