The following is a summary of “ICD-10-CM codes infrequently used to document human trafficking in 2019 Nationwide Emergency Department Sample,” published in the November 2022 issue of Emergency Medicine by Dell, et al.
Emergency departments (ED) see individuals who are victims of human trafficking (HT). In June 2018, codes to describe HT were added to the ICD-10-CM, an updated classification of diseases. For a study, researchers sought to pinpoint the characteristics of ED patients who had endured forced labor or sexual exploitation as a recognized external source of morbidity in US visits.
In 2021, nationally representative monitoring was made accessible based on patient visits to 989 hospital-owned EDs in the Nationwide Emergency Department Sample in 2019. In order to analyze HT as an external cause of morbidity in 2021–2022, eight ICD-10–CM codes were aggregated into one HT variable.
The external source of morbidity for HT was identified by a weighted count of 517 out of 33.1 million ED visits (0.0016%). In comparison to labor exploitation (28.4%), sexual exploitation (71.6%) was reported more frequently. The majority of HT-related codes were made by white females from large urban locations (87.3%). Nearly 40% of visits were from ZIP areas with a median yearly household income of less than $48,000. Patients who presented to the emergency department (ED) with HT as an external cause of morbidity had increased chances of being female (OR = 6.54, 95% CI:3.59, 11.92) and being a minor (OR = 1.76, 95% CI:1.02, 3.04) compared to all other ED visits.
In 989 hospital emergency department visits from a nationally representative sample in 2019, HT was infrequently recorded as an external cause of morbidity. Recently new HT ICD-10-CM codes don’t seem to have been deployed well enough to produce an accurate depiction of people who experienced HT and sought treatment in the ED. The ED staff’s training on HT detection and response must be addressed before any efforts to increase the value of ICD-10-CM HT codes for surveillance and documentation. In doing so, ED staff must also address ethical issues (such as stigma, secrecy, and the potential for patient damage) and permit informed permission from patients who have been victims of human trafficking in order to scale up operations ethically.