Coding Corner: ICD-10 unveils new diagnostic codes to report human trafficking

September 11, 2018
Area(s) of Interest: Payor Issues and Reimbursement Practice Management 

CPR’s “Coding Corner” focuses on coding, compliance, and documentation issues relating specifically to physician billing. This month’s tip comes from Brad Ericson, the director of publishing for AAPC, a training and credentialing association for the business side of health care.

Effective for fiscal year 2019, ICD-10 will include new diagnostic codes to report confirmed and suspected cases of human trafficking. Additionally, new codes will be available for patient history of labor or sexual exploitation, encounters for examination and observation following sexual or labor exploitation, and to identify multiple perpetrators of maltreatment and neglect. The codes are the first of their kind to document confirmed and suspected cases of forced sex and labor exploitation for patients who visit hospitals or medical facilities for treatment and may be assigned in addition to other existing ICD-10 codes for abuse, neglect and other maltreatment. Most of these codes require additional characters.


Adult forced sexual exploitation, confirmed


Child sexual exploitation, confirmed


Adult forced labor exploitation, confirmed


Child forced labor exploitation, confirmed


Adult forced sexual exploitation, suspected


Child sexual exploitation, suspected


Adult forced labor exploitation, suspected


Child forced labor exploitation, suspected


Multiple perpetrators of maltreatment and neglect


Encounter for examination and observation of victim following forced sexual exploitation


Encounter for examination and observation of victim following forced labor exploitation


Personal history of forced labor or sexual exploitation in childhood


Personal history of forced labor or sexual exploitation

A variety of stakeholders, including the American Hospital Association (AHA) Hospitals Against Violence (HAV) initiative,  joined forces to lobby for creation of the new codes. The Centers for Disease Control and Prevention first published the codes on June 11, and they take effect October 1, 2018.

Trafficking terms in documentation

Victims of human trafficking are often identified by a number of signs, including an unusual combination of injuries, failure to promptly seek care when hurt or sick, or unwillingness to interact with staff. AHA encourages medical coders to watch for the following terms in medical documentation:

  • Human trafficking
  • Labor trafficking
  • Sex trafficking
  • Commercial sexual exploitation
  • Forced commercial sexual exploitation
  • Forced prostitution
  • Forced sexual exploitation
  • Forced labor exploitation
  • Exploitation of manual labor
  • Exploitation of sexual labor
  • Exploitation for manual labor
  • Exploitation for commercial sex
  • Domestic servitude
  • Labor exploitation for domestic work
  • Force labor exploitation for domestic work

Trafficking isn’t always recognized

Understanding the scope and extent of human trafficking is an important first step to preventing it, and this is where the new codes can make a difference. AHA contends, “Tracking confirmed and suspected cases in the health care system will allow hospitals and health systems to better track victim needs and identify solutions to improve the health of their communities. It also provides another source for data collection to inform public policy and prevention efforts, as well as support the systemic development of an infrastructure for services and resources.”

Medical providers and coders are being encouraged to begin using the codes, and to educate their peers. As part of this effort, the HAV initiative launched a human trafficking website in July to provide guidance on documenting and coding human trafficking.

Unfortunately, health care providers often see victims of human trafficking without realizing their situation. Kaiser Health News and National Public Radio  cite a 2014 survey of approximately 100 survivors of sex trafficking, in which 88 percent of respondents said that during the time they were being trafficked, they had contact with a health care provider (usually in an emergency department). Continued awareness, as indicated by the creation of human trafficking codes in ICD-10, may help to reverse that situation.


Was this article helpful?    
Download the New CMADocs app!

Download the new CMADocs app!

CMA's new mobile app lets you connect with your colleagues and engage with CMA content!  Download the "CMADocs" app today from the Apple or Google Play app stores for daily news updates, events calendar, resource library and more.

Latest News

Load More