Skip to main content Accessibility help
Hostname: page-component-55597f9d44-mzfmx Total loading time: 0.269 Render date: 2022-08-18T17:56:58.312Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true } hasContentIssue true

Principles for Safe Implementation of ICD Codes for Human Trafficking

Published online by Cambridge University Press:  29 June 2021


Human trafficking is associated with a variety of adverse health and mental health consequences, which should be accurately addressed and documented in electronic health records.

Independent Articles
© 2021 The Author(s)

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


United Nations, Protocol to Prevent, Suppress and Punish Trafficking in Persons Especially Women and Children, Supplementing the United Nations Convention Against Transnational Organized Crime (2000), available at <> (last visited May 10, 2020).+(last+visited+May+10,+2020).>Google Scholar
Kiss, L., Pocock, N.S., Naisanguansri, V., Suos, S., Dickson, B., Doan, T., Koehler, J., Sirisup, K., Pongrungsee, N., Anh, N. Van, Borland, R., Dhavan, P., and Zimmerman, C., “Health of Men, Women, and Children in Post-Trafficking Services in Cambodia, Thailand, and Vietnam: An Observational Cross-Sectional Study,Lancet Global Health 3 (2015): e154-e161; S. Oram, M. Abas, B. Bick, A. Boyle, R. French, and et al., “Human Trafficking and Health: A Survey of Male and Female Survivors in England,” American Journal of Public Health 106 (2016): 1073-1078; N.S. Pocock, L.H. Nguyen, D.E. Lucer-Prisno, C. Zimmerman and S. Oram, “Occupational, Physical, Sexual and Mental Health and Violence Among Migrant and Trafficked Commercial Fishers and Seafarers from the Greater Mekong Subregion: A Systematic Review,” Global Health Research and Policy 3 (2018): 28-41; L. Ottisova, S. Hemmings, L.M. Howard, C. Zimmerman, and S. Oram, “Prevalence and Risk of Violence and the Mental, Physical and Sexual Health Problems Associated With Human Trafficking: An Updated Systematic Review,” Epidemiology Psychiatry & Science 25, no. 4 (2016): 317-341, doi:10.1017/S2045796016000135; International Labour Organization, Towards the Urgent Elimination of Hazardous Child Labour (2018), available at <> (last visited May 9, 2020); L. Ottisova, P. Smith, and S. Oram, “Psychological Consequences of Human Trafficking: Complex Posttraumatic Stress Disorder in Trafficked Children,” Behavioral Medicine 44 (2018): 234-241.CrossRefGoogle Scholar
Albright, K., Greenbaum, J., Edwards, S., and Tsai, C., “Systematic Review of Facilitators of, Barriers to, and Recommendations for Healthcare Services for Child Survivors of Human Trafficking Globally,” Child Abuse & Neglect 100 (2020): 1-27; S. Armstrong and V.J. Greenbaum, “Using Survivors’ Voices to Guide the Identification and Care of Trafficked Persons by U.S. Health Care Professionals: A Systematic Review,” Advances in Emergency Nursing Journal 41 (2019): 244-260.Google Scholar
Katsanis, S.H., Huang, E., Young, A., Grant, V., Warner, E., and Larson, S., “Caring for Trafficked and Unidentified Patients in the EHR Shadows: Shining a Light by Sharing the Data,” PLoS ONE 14, no. 3 (2019): e0213766, available at <> (last visited April 12, 2021).CrossRefGoogle ScholarPubMed
See Ottisova, supra note 2; Cary, M., Oram, S., Howard, L.M., Trevillion, K., and Byford, S., “Human Trafficking and Severe Mental Illness: An Economic Analysis of Survivors’ Use of Psychiatric Services,” BMC Health Services Research 16 (2016): 284-290.CrossRefGoogle ScholarPubMed
Karakurt, G., Patel, V., Whiting, K., and Koyuturk, M., “Mining Electronic Health Records Data: Domestic Violence and Adverse Effects,” Journal of Family Violence 32 (2017): 79-87; E. Miller, B. McCaw, B.L. Humphreys, and C. Mitchell, “Integrating Intimate Partner Violence Assessment and Intervention Into Healthcare in the United States: A Systems Approach,” Journal of Women’s Health 24 (2015): 92-99; E. Sigel, S.B. Harpin and G. Tung, “Increasing Documentation and Referral for Youth at Risk for Violence Through the Primary Health Care Setting,” Clinical Pediatrics 54 (2015): 451-457.CrossRefGoogle Scholar
American Hospital Association, “Factsheet: ICD-10-CM Coding for Human Trafficking” (2018) available at <> (last visited on May 2, 2020).+(last+visited+on+May+2,+2020).>Google Scholar
U.S. Department of Health and Human Services, Office on Trafficking in Persons, International Centre for Missing and Exploited Children and HEAL Trafficking, “Human Trafficking ICD Code Convening — Identifying Electronic Health Record Recommendations to Improve Patient Safety and Clinical Care for Trafficked Persons. Dec 5, 2019. Washington, D.C.,”Google Scholar
W.J. Rudman, “Coding and Documentation of Domestic Vio-lence,” Produced by Family Violence Prevention Fund (2000), available at <> (last visited on May 12, 2020); Drinkwater, J., Stanley, J., Szilassy, E., Larkins, C., Hester, M., Feder, G., “Juggling Confidentiality and Safety: A Qualitative Study of How General Practice Clinicians Document Domestic Violence in Families With Children,” British Journal General Practice 67 (2017): 3437-3444.+(last+visited+on+May+12,+2020);+Drinkwater,+J.,+Stanley,+J.,+Szilassy,+E.,+Larkins,+C.,+Hester,+M.,+Feder,+G.,+“Juggling+Confidentiality+and+Safety:+A+Qualitative+Study+of+How+General+Practice+Clinicians+Document+Domestic+Violence+in+Families+With+Children,”+British+Journal+General+Practice+67+(2017):+3437-3444.>Google Scholar
Rothstein, M. A., “The Hippocratic Bargain and Health Information Technology,” Journal of Law, Medicine & Ethics 38, no. 1 (2010): 7-13.CrossRefGoogle ScholarPubMed
See Rudman, supra note 9; Williams, M., “Confidentiality of the Medical Records of HIV-Positive Patients in the United Kingdom: A Medicolegal and Ethical Perspective,” Risk Management and Healthcare Policy 4 (2011): 15-26; L. Lin and B.A. Liang, “HIV and Health Law: Striking a Balance Between Legal Mandates and Medical Ethics,” American Medical Association Journal of Ethics 7 (2005): 687-692; U.S. Department of Justice and Office for Victims of Crime, “SANE Program Development and Operation Guide,” (2020), available at <> (last visited December 25, 2019); U.S. Department of Justice and Office on Violence Against Women, “A National Protocol for Sexual Assault Medical Forensic Examinations,” (2013), available at <> (last visited on April 20, 2020); N. Calman, H.R. Pfister, R. Lesnewski, D. Hauser, and N. Shroff, “Electronic Access to Adolescents’ Health Records: Legal, Policy and Practice Implications,” (2014), available at <> (last visited on Feb 2, 2020); A. Anoshiravani, G.L. Gaskin, M.R. Groshek, C. Kuelbs, and C.A. Longhurst, “Special Requirements for Electronic Medical Records in Adolescent Medicine,” Journal of Adolescent Health 51 (2012): 409-414; Society for Adolescent Health and Medicine, “Recommendations for Electronic Health Record Use for Delivery of Adolescent Health Care: Position Paper,” Journal of Adolescent Health 54 (2014): 487-490.+(last+visited+December+25,+2019);+U.S.+Department+of+Justice+and+Office+on+Violence+Against+Women,+“A+National+Protocol+for+Sexual+Assault+Medical+Forensic+Examinations,”+(2013),+available+at++(last+visited+on+April+20,+2020);+N.+Calman,+H.R.+Pfister,+R.+Lesnewski,+D.+Hauser,+and+N.+Shroff,+“Electronic+Access+to+Adolescents’+Health+Records:+Legal,+Policy+and+Practice+Implications,”+(2014),+available+at++(last+visited+on+Feb+2,+2020);+A.+Anoshiravani,+G.L.+Gaskin,+M.R.+Groshek,+C.+Kuelbs,+and+C.A.+Longhurst,+“Special+Requirements+for+Electronic+Medical+Records+in+Adolescent+Medicine,”+Journal+of+Adolescent+Health+51+(2012):+409-414;+Society+for+Adolescent+Health+and+Medicine,+“Recommendations+for+Electronic+Health+Record+Use+for+Delivery+of+Adolescent+Health+Care:+Position+Paper,”+Journal+of+Adolescent+Health+54+(2014):+487-490.>Google Scholar
See U.S. Department of Health and Human Services, supra note 8.Google Scholar
Sutherland, M.A. and Hutchinson, M.K., “Organizational Influences on the Intimate Partner Violence and Sexual Violence Screening Practices of College Health Care Providers,” Research Nursing and Health 42 (2019): 284-295; R. Onder, J. Spillan, B. Reilley, and J. Leston, “Use of Electronic Clinical Reminders to Increase Preventive Screenings in a Primary Care Setting; Blueprint From a Successful Process in Kodiak, Alaska,” (2014), Journal of Primary Care & Community Health 5 (2014): 50-54.CrossRefGoogle ScholarPubMed
English, A., “Mandatory Reporting of Human Trafficking: Potential Benefits and Risks of Harm,” AMA Journal of Ethics 19 (2017): 54-62.Google ScholarPubMed
Atkinson, H.G., Curnin, K.J., and Hanson, N.C., “U.S. State Laws Addressing Human Trafficking: Education of and Mandatory Reporting by Health Care Providers and Other Professionals,” Journal of Human Trafficking 2 (2016): 111-138.CrossRefGoogle Scholar
Rubino, F., Puhl, R.M., Cummings, D.E., Eckel, R.H., Ryan, D.H., Mechanick, J.I., and et al., “Joint International Consensus Statement for Ending Stigma of Obesity,” Nature Medicine 26 (2020): 485-497; World Health Organization, “Agenda for Zero Discrimination in Healthcare,” (2016) available at <> (last visited on May 3, 2020).CrossRefGoogle ScholarPubMed
See Society for Adolescent Health and Medicine, supra note 11.Google Scholar
See Society for Adolescent Health and Medicine, supra note 11.Google Scholar
See e.g., Cal. Health & Safety Code § 123115 which requires providers to obtain the consent of minor patients prior to permitting a parent or guardian to access information related to certain services and permits providers to refuse parental access to medical records, even if the parent would otherwise have a right to them, if such access would have a detrimental effect on the provider’s relationship with the patient or the minor’s physical safety or psychological wellbeing; See also Cal. Penal Code § 11166 which requires providers to report any instance of suspected abuse of a child to listed federal and state agencies.Google Scholar
Lee, B.S., Walker, J., Delbanco, T., and Elmore, J.G., “Transparent Electronic Health Records and Lagging Laws,” Annals of Internal Medicine 165 (2016): 219-220.CrossRefGoogle ScholarPubMed
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the or variations. ‘’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Principles for Safe Implementation of ICD Codes for Human Trafficking
Available formats

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Principles for Safe Implementation of ICD Codes for Human Trafficking
Available formats

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Principles for Safe Implementation of ICD Codes for Human Trafficking
Available formats

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *