Peer-reviewed article
ICD-10 Codes Used in Pediatric Exposure to Intimate Partner Violence.
Sayeem M, Shum M, Ryus C, Powers E, Randell KA et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how healthcare providers in the United States document children's exposure to intimate partner violence using diagnostic codes. Researchers reviewed 92 pediatric visits at an emergency department and child advocacy center and found that 85% of visits were assigned diagnostic codes related to abuse or social concerns. The study found significant differences in coding practices between the two types of facilities, suggesting inconsistency in how providers document these cases.
Key points
- 174 distinct ICD-10 codes were identified across 92 pediatric encounters related to intimate partner violence exposure
- 85% of encounters were associated with IPV-related diagnostic codes or social concern codes
- Child advocacy centers used IPV-related diagnostic codes in 98% of cases compared to 66% in pediatric emergency departments
- Common code groups used were Z63, T74, T76, and Z60, but these lack specificity for identifying IPV exposure
- ICD-10 codes alone may not be sufficient for systematically identifying pediatric IPV exposure due to variability in documentation practices
Limitations
This is a single-site study from one urban healthcare system, so findings may not generalize to other settings or regions. The study describes coding practices rather than evaluating whether better coding improves child safety outcomes or clinical care.
Abstract
Objective Identify common diagnostic codes for pediatric visits related to caregiver intimate partner violence (IPV) in a health care system. Methods We conducted a secondary analysis of pediatric encounters for IPV-related care at a single urban health care system from July 2019 to June 2022. The study included visits to the pediatric emergency department (PED) or child advocacy center (CAC) following a child protective service referral. ICD-10-CM codes associated with each visit were descriptively summarized. We examined the relationship between the site of evaluation and the use of IPV-related diagnostic codes. Results Among 92 pediatric encounters (39 in the PED, 53 in the CAC), we identified 174 distinct ICD-10 codes. A majority of encounters, 78 (85%), were associated with IPV-related diagnostic codes, suspected abuse and/or a social concern (eg, Z63, T74, T76, Z60). CAC encounters were more likely to have IPV-related diagnostic codes when compared to PED evaluations (98% vs 66%, P<.01). Conclusion(s) In the current study, ICD-10 code groups Z63, T74, T76, and Z60 were frequently used to document IPV exposure; however, their use varied significantly between the CAC and the PED. This variability may reflect both uncertainty among health care providers regarding documentation practices, along with concerns about the safety of children and caregivers following such disclosure. Additionally, the identified code groups lack specificity for IPV, limiting their effectiveness for systematically identifying such encounters. Given these limitations, ICD-10 codes alone may not constitute a robust mechanism for identifying IPV exposure in pediatric encounters.