More harm than good? Diagnostic codes for child and adult abuse

Violence Vict. 2003 Oct;18(5):491-502. doi: 10.1891/vivi.2003.18.5.491.


This study sought to understand the reasons for the lack of use of ICD diagnostic codes for child and adult abuse. New Jersey professionals were recruited to participate in three focus groups on child abuse, adult or primarily woman abuse, and elder abuse. Participants included health care providers, advocates from the community, and representatives of state agencies and the insurance industry. Concerns about coding abuse included further jeopardizing victims/patients, diagnostic uncertainty, and lack of resources. Members of the child abuse group were somewhat more receptive to coding abuse. Reasons to code, such as for documentation and reimbursement were discussed and rebutted. Most participants concluded that use of the abuse codes should be judicious because they have the potential to do more harm than good. More research is needed on the implications of coding for victims/patients along with medical education in the identification of abuse in general and coding abuse in particular.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Child Abuse / classification*
  • Child, Preschool
  • Confidentiality
  • Crime Victims
  • Elder Abuse / classification*
  • Female
  • Health Services Research
  • Humans
  • International Classification of Diseases*
  • Middle Aged
  • New Jersey
  • Safety
  • Spouse Abuse / classification*