Domestic Violence and Healthcare- Domestic violence and dating violence, taken together, is called intimate partner violence. Intimate partner violence (IPV) involves a pattern of behavior by which one person in an intimate relationship uses one or more forms of abuse to victimize his or her partner. It involves that individual gaining power over the other person in their relationship; he or she uses that power to control and change the behavior of the victim. This kind of abuse can happen to anyone, regardless of age, race or ethnicity, gender, socioeconomic status, or religion. It can include various kinds of abuse from psycho-emotional and identity abuse to cultural and economic abuse, and of course, violent physical and/or sexual abuse. 

Millions of Americans are violently abused each year by intimate partners and seek out healthcare treatment for their injuries. The Centers for Disease Control and Prevention (CDC) published a report based on their National Intimate Partner and Sexual Violence Survey (NISVS) that shows that about 1 in 4 women and close to 1 in 10 men have experienced violence and/or stalking by an intimate partner and reported some form of IPV-related impact to their lives. The CDC also notes that the problem of IPV does not just apply to adults, but also teens during their adolescent years; it is referred to as teen dating violence (TDV). TDV affects teens similarly: about 11 million women and 5 million men first experienced this kind of violence before age 18.

IPV/TDV has developed into a major public health problem in America because so many victims experience physical injury due to the violence, but it often is not documented; this makes it more difficult to understand the sociological impact of violent abuse. There are many reasons that healthcare providers sometimes do not document domestic violence and that health information management professionals are unable to code it accurately. For instance, sometimes providers do not screen for domestic violence, even when a patient presents with injuries that are regularly the result of domestic violence; patients are not always asked about the cause(s) of their injuries for certain reasons and they often do not disclose details or related information voluntarily (for a variety of reasons). Without documentation, accurate medical coding is impossible.

Thorough, clear documentation of domestic violence and accurate medical coding of injuries related to it is critically beneficial to all parties. A medical record that includes treatment or care for IPV- or TDV-related injuries demonstrates a need for a more robust and pointed response to domestic violence. Further, precise and complete documentation and coding allow for continuity of care for patients, so their cases don’t get shuffled to different providers; having a set provider helps to develop a clear picture of the part played by abuse and help to identify possible patterns of violence as well as the mental health impact. Outside of benefiting victims, information collected via medical documentation and coding significantly informs reviews and official revisions to clinical guidelines in a positive way.

Documentation and coding of domestic violence also relate directly to healthcare provider reimbursement. In “Coding and Documentation of Domestic Violence,” written in 2000 by Professor William J. Rudman of the University of Mississippi Medical Center School of Health Related Professions, it states, “Because victims may need services beyond the treatment of physical injuries, such as risk assessment, counseling, safety planning and referral outside the health care system, proper documentation and coding can facilitate reimbursement to providers for these important additional services. Providers will be more likely to incorporate domestic violence screening and intervention into their practice if they are adequately reimbursed for their time.”

 

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Another way that accurate documentation and coding of IPV/TDV and related injuries are beneficial in other settings and on a system-wide level is that it can be used to help victims who pursue legal cases against the perpetrators of the violent abuse. A detailed medical record can provide persuasive evidence in legal proceedings. (This is significant also because it could decrease the chance that a healthcare provider may be asked to testify in such a case because by making it known to the abuser that there is evidence of the abuse, he or she might be convinced to settle before the case goes to court.) For healthcare providers, an additional point to consider (aside from the ethical call against malfeasance) is that they can be considered complicit and held accountable for failure to diagnose and/or respond to any suspected abuse; appropriate documentation can protect providers from potential liability.

Without clear and comprehensive documentation and accurate coding of intimate partner violence and teen dating violence, healthcare systems cannot offer the kind of large-scale data needed to help fully implement and sustain screening guidelines for providers. Moreover, such documentation and coding also can drastically improve the ability of researchers to conduct impactful large-scale investigations of the issues of IPV and TDV. It also positively affects reimbursement for screening, identification, assessment, and care and treatment of victims. Healthcare professionals should consider their critical role in helping to end IPV and TDV.

 

Quick Claimers Medical Billing is a professional medical coding and billing company based in El Paso, Texas. Quick Claimers is committed to serving healthcare professionals like you by providing medical coding and billing solutions that support productivity and payment for all the care and treatment you provide. The coding and billing specialists at Quick Claimers stay abreast of changes in the coding and billing industry that will affect how your healthcare claims are processed and paid, so they can ensure that you are compensated for your services by patients and reimbursed by insurance companies for all the care and treatment delivered. If you would like more information about how Quick Claimers Medical Billing can help support you as you maintain your healthcare practice, please reach out to the competent and caring professional team by email at info@qcmbinc.com or via their online form, or by calling 915-351-6600.

 

Written by: Erika Mehlhaff