Health Information Management

October: Domestic Violence Awareness Month

Coding Educator, October 1, 2008

by Cindy Basham, MHA, MSCCS,  BSN, CCS, CPC

Every year, when the month of October arrives, my thoughts return to a time years ago when a young woman crossed my path for a brief moment. This brief encounter forever changed my outlook on life and love.

One October evening, “C” arrived at the hospital emergency room (ER) unaccompanied, seeking treatment for her “clumsy” fall down a flight of stairs. I was covering triage when she walked in and sat down at the desk. I was struck first by the massive amount of bruising and swelling on her small face, the streaks of tears on her cheeks, and the abnormal shape of her clearly broken lower left arm. I completed her initial assessment and escorted her back to a treatment room.

Throughout the entire ordeal, she told the same story about falling down stairs even though her injuries indicated a much uglier reality. The ER physician confronted her with this fact, but she held fast to her story. After treatment, she left the ER quietly without waiting for her discharge information, prescription, and information on follow-up visits. We all wondered whether we would see her again. Later that week, we did. Only that visit turned out to be the last. She was pronounced dead on arrival.

Although C’s story is all too familiar, domestic violence rarely makes the evening news or finds space in the local paper. This sort of violence affects not just the victims themselves, but their families and the community at large. Here are a few facts from the US Department of Justice, Bureau of Justice Statistics, and the Centers for Disease Control and Prevention listed on the fact sheet from the National Coalition Against Domestic Violence (NCADV):
  • Each year, an estimated 1.3 million women are victims of physical assault by an intimate partner.
  • Females make up the majority (73%) of family violence victims. Females make up 84% of spousal abuse victims. Additionally, 86% of victims suffer at the hands of a boyfriend.
  • Almost one-third of female homicide victims are killed by an intimate partner.
  • Less than one-fifth of victims who report an injury from intimate partner violence seek medical treatment following the injury.
  • Intimate partner violence results in more than 18.5 million mental health care visits each year.
  • The cost of intimate partner violence exceeds $5.8 billion each year, $4.1 billion of which is for direct medical and mental health services.
In 2008, NCADV celebrates its 30th year as the only national organization that offers grassroots shelter and services for battered women. The organization works with legislators to develop and fund national policies like the Violence Against Women Act. It sponsors conferences and forums on domestic violence. Today there are more than 2000 shelters and service programs available to victims of violence and their children.

The new ICD-9-CM codes for 2009 include a selection of family disruption codes (V61.xx) which may be appropriate for some domestic violence situations: V61.03 for family disruption due to divorce or legal separation and V61.09 for other family disruption.

Acute injuries due to domestic violence are assigned diagnosis codes. For those that seek mental health counseling, the diagnosis code should be a V-code for counseling. Use the V-codes for counseling when a patient receives assistance in the aftermath of an illness, injury, or when support is required for coping in certain situations.

For more information on how you can help fight domestic violence, go to the NCADV Web site at www.ncadv.org/.

Editor’s note: Contact Cindy Basham, MHA, MSCCS, BSN, CCS, CPC, at cbasham@hcpro.com.

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