T74.12XD — Child physical abuse, confirmed, subsequent encounter
T74.12XD is a billable, specific ICD-10-CM code for child physical abuse, confirmed, subsequent encounter. It is valid for submission on a claim.
7th character "D" — subsequent encounter
The appropriate 7th character is to be added to each code from category T74
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- shaken infant syndrome (T74.4)
Risk adjustment
T74.12XD 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.
Medicare coverage
T74.12XD is named in 7 Medicare coverage policies — 7 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
- A56612Billing and Coding: CT of the Head
- A56726Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
- A56726Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
Related codes at this level
Codes that share T74.12. If T74.12XD is not quite right, the correct code is usually one of these.
Questions about T74.12XD
- Is T74.12XD a billable ICD-10-CM code?
- Yes. T74.12XD is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T74.12XD 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).