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Area of Science:

  • Pediatric healthcare
  • Public health
  • Medical coding

Background:

  • Intimate partner violence (IPV) significantly impacts child well-being.
  • Accurate identification of IPV exposure in pediatric settings is crucial for intervention.
  • Current diagnostic coding practices may not effectively capture all IPV-related pediatric encounters.

Purpose of the Study:

  • To identify common International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes used for pediatric visits related to caregiver IPV.
  • To compare the use of IPV-related diagnostic codes between pediatric emergency department (PED) and child advocacy center (CAC) evaluations.
  • To assess the specificity and effectiveness of ICD-10 codes for identifying IPV in pediatric healthcare settings.

Main Methods:

  • Secondary analysis of pediatric encounters for IPV-related care from July 2019 to June 2022.
  • Inclusion of visits to the PED or CAC following a child protective service referral.
  • Descriptive summarization of ICD-10-CM codes and examination of code usage based on evaluation site.

Main Results:

  • 174 distinct ICD-10 codes were identified across 92 pediatric encounters.
  • 85% of encounters were associated with IPV-related diagnostic codes, suspected abuse, or social concerns (e.g., Z63, T74, T76, Z60).
  • Child advocacy center (CAC) encounters were significantly more likely to have IPV-related codes than pediatric emergency department (PED) evaluations (98% vs. 66%, p <0.01).

Conclusions:

  • ICD-10 code groups Z63, T74, T76, and Z60 are frequently used but lack specificity for IPV.
  • Variability in code usage between CAC and PED settings may indicate provider uncertainty or safety concerns.
  • ICD-10 codes alone are insufficient for robustly identifying pediatric IPV exposure due to limited specificity and documentation inconsistencies.