The following new subcategories were created to uniquely identify forced labor and sexual exploitation:
- T74.51- Adult forced sexual exploitation, confirmed
- T74.52- Child sexual exploitation, confirmed
- T74.61- Adult forced labor exploitation, confirmed
- T74.62- Child forced labor exploitation, confirmed
- T76.51- Adult forced sexual exploitation, suspected
- T76.52- Child sexual exploitation, suspected
- T76.61- Adult forced labor exploitation, suspected
- T76.62- Child forced labor exploitation, suspected
In addition, two new Z codes were created to identify an encounter for examination and observation of victim following forced sexual exploitation (Z04.81) or forced labor exploitation (Z04.82), as well as two new codes for personal history of forced labor or sexual exploitation (Z62.813 and Z91.42).
Category Y07, Perpetrator of assault, maltreatment and neglect, was expanded with new code Y07.6, Multiple perpetrators of maltreatment and neglect, to identify situations where multiple perpetrators are involved.
Human trafficking is a key concern for hospitals across the country as this is a public health concern. Human trafficking is modern day slavery, a human rights violation and criminal enterprise that affects millions of people across the globe including the United States. Common purposes of human trafficking in the United States are for forced sexual exploitation and/or forced labor exploitation, including domestic servitude.
The new codes are intended to help differentiate these patients from other victims of abuse. The effects of both sex and labor trafficking can be devastating for individuals, families, communities and the greater society. Those effects can include consequences for immediate and long term health and well-being. Trafficked persons can experience physical, psychological and social trauma leading to a broad spectrum of needs.
The International Labour Organization (ILO) estimates that 20.9 million people are trafficked worldwide. However, this is only an estimation and the ILO acknowledges challenges in accurately accounting for the prevalence and incidence of human trafficking due to its subversive nature, with many occurrences concealed in work sectors where exploited labor is disguised as conventional employment or invisible altogether.
Health care providers have a significant opportunity to identify and assist victims of human trafficking. Studies show that 50% - 87% of trafficking survivors reported being seen by a health care professional while they were being trafficked. Victims are treated in emergency departments, health clinics, physician offices, urgent care centers or other care settings.
There are efforts underway to train health care providers to identify and respond to victims of human trafficking who present for care. Providers will be made aware of the use of the terms “human trafficking” and “forced labor” and “forced sexual exploitation.”
Key terms related to human trafficking used in medical documentation include:
- 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