T74 — Adult and child abuse, neglect and other maltreatment, confirmed
T74 is a non-billable header ICD-10-CM code for adult and child abuse, neglect and other maltreatment, confirmed. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.
This code requires a 7th character
The appropriate 7th character is to be added to each code from category T74
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- abuse and maltreatment in pregnancy (O9A.3-, O9A.4-, O9A.5-)
- adult and child maltreatment, suspected (T76.-)
Use additional code
Add a secondary code to capture the detail described below.
- code, if applicable, to identify any associated current injury
- external cause code to identify perpetrator, if known (Y07.-)
Other codes that can never be billed with T74
These codes carry an Excludes1 note pointing at T74. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading T74 alone.
- Z91.410Personal history of adult physical and sexual abuse
- Z91.412Personal history of adult neglect
- T76Adult and child abuse, neglect and other maltreatment, suspected
- Z04.71Encounter for examination and observation following alleged adult physical abuse
- Z04.72Encounter for examination and observation following alleged child physical abuse
- Z62.810Personal history of physical and sexual abuse in childhood
- Z62.811Personal history of psychological abuse in childhood
- Z62.812Personal history of neglect in childhood
Risk adjustment
T74 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code to one of these instead T74
9 child codes. Green means billable.
- T74.0Neglect or abandonment, confirmed
- T74.1Physical abuse, confirmed
- T74.2Sexual abuse, confirmed
- T74.3Psychological abuse, confirmed
- T74.4Shaken infant syndrome
- T74.5Forced sexual exploitation, confirmed
- T74.6Forced labor exploitation, confirmed
- T74.9Unspecified maltreatment, confirmed
- T74.AFinancial abuse, confirmed
Questions about T74
- Is T74 a billable ICD-10-CM code?
- No. T74 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does T74 sit in the tabular list?
- Injury, poisoning and certain other consequences of external causes (S00-T88), in the block Other and unspecified effects of external causes (T66-T78).
- What cannot be coded together with T74?
- T74 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.