Catholic Health Initiatives Helps Lead Campaign to Create New ICD-10 Codes on Human Trafficking

Catholic Health initiatives helped spearhead an 18-month-long effort to create a diagnostic code that will allow medical professionals to identify victims of human trafficking when they arrive at facilities seeking health care.

CHI, one of the nation’s largest nonprofit health systems, collaborated with the American Hospital Association’s Hospitals Against Violence (HAV) initiative and clinicians at Massachusetts General Hospital’s Human Trafficking Initiative and Freedom Clinic to develop and secure ICD-10 codes that will allow providers to document sex and labor exploitation for the first time.

The 29 human-trafficking-related codes, published by the Centers for Disease Control and Prevention on June 11, will help providers identify victims and respond appropriately to assist victims. Set to take effect in October, the codes also will also provide much-needed data to understand the scope of this problem.

“Like victims of child abuse or elder abuse, victims of human trafficking are coming into emergency rooms and health care facilities on a daily basis -- and we have to be ready,’’ said Colleen Scanlon, senior vice president and chief advocacy officer for Englewood, Colo.-based Catholic Health Initiatives. “This is a significant step forward. Having these codes will help clinicians adequately classify a diagnosis and plan appropriate treatment. And it will demonstrate that this is a serious problem that must be stopped.’’

The new codes will be used to identify and document both confirmed and suspected cases of forced sexual and labor exploitation of children and adults who go to a hospital or medical facility for treatment of an injury, illness or condition. Like other ICD codes, they serve as an official diagnosis to describe diseases, causes of diseases and death.

Over the past several years, human trafficking has become a public health concern that is growing nationwide. Between 2007 and 2017, the National Human Trafficking Resource Center received more than 40,000 reports of human trafficking cases in the U.S.

Hospitals are in a unique position to identify and assist victims. One study found that almost 88 percent of sex-trafficking survivors surveyed said they had had contact with a health care provider while they were being exploited. The most frequent site referenced was a hospital emergency department. Victims may seek treatment for occupational injuries, sexually transmitted diseases or pregnancy and HIV tests, or a host of other acute and chronic illnesses.

“Human trafficking is hiding in plain sight -- we know victims are seeking care,’’ said Wendy L. Macias Konstantopoulos, M.D., who is director of Massachusetts General Hospital’s Human Trafficking Initiative in Boston and served as the physician expert in the effort to win approval of the new codes. “Hospitals can and must take a leadership role in identifying victims and raising awareness about the issue. 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.’’

“The adoption of these codes is a huge step forward in combating human trafficking,” said Nelly Leon-Chisen, AHA’s Director of Coding and Classification, who was instrumental in developing and shepherding the codes through the approval process. “It will be crucially important for coding professionals to understand how to recognize and use these codes.” Coders and other medical professionals will find more guidance on documenting and coding human trafficking on the HAV human trafficking website that will be launched later this month.

After the release of the codes, The Joint Commission, an independent, nonprofit group that accredits nearly 21,000 health care organizations and programs in the U.S., issued a safety notice identifying the signs of human trafficking and what steps medical professionals should take when they suspect a patient might be a victim.

CHI’s work on the diagnostic codes coincides with its other efforts to prevent human trafficking. In South Dakota, CHI worked to raise awareness of the signs of sex trafficking, especially at hotels and truck stops. In Kentucky, CHI helped pass legislation that imposed stiffer penalties on human trafficking, provided identification training and ensured safe harbor for victims. And in Houston, CHI is working to unite hospitals and health providers on best practices in identifying and effectively responding to victims. At the system level, CHI provides resources and consultation for all forms of violence prevention and has developed specific education on human trafficking identification and response in the health care setting.“There is great acceptance that human trafficking is a serious public health concern,’’ said Scanlon. “As a large, faith-based health system operating in 18 states, we have a moral obligation to do whatever we can to stop this suffering. The new diagnostic codes will help doctors and other health care providers know what to ask -- and how to respond.’’

ABOUT CATHOLIC HEALTH INITIATIVES: Catholic Health Initiatives, a nonprofit, faith-based health system formed in 1996 through the consolidation of four Catholic health systems, expresses its mission each day by creating and nurturing healthy communities in the hundreds of sites across the nation where we provide care. One of the nation’s largest nonprofit health systems, Englewood, Colo.-based CHI operates in 18 states and comprises 99 hospitals, including two academic health centers, major teaching hospitals and 29 critical-access facilities; community health-services organizations; accredited nursing colleges; home-health agencies; living communities; and other facilities and services that span the inpatient and outpatient continuum of care. In fiscal year 2017, CHI provided more than $1.2 billion in financial assistance and community benefit for programs and services for the poor, free clinics, education and research. Financial assistance and community benefit totaled approximately $2.1 billion with the inclusion of the unpaid costs of Medicare. The health system, which generated operating revenues of $15.5 billion in fiscal year 2017, has total assets of approximately $22 billion. Learn more at www.catholichealthinitiatives.org www.catholichealthinitiatives.org.