T74.21XA
T74.21XA: Adult sexual abuse, confirmed, initial encounter
Billable / specific codeICD-10-CM
T74.21XA is a billable, specific ICD-10-CM code for adult sexual abuse, confirmed, initial encounter. It is valid for submission on a claim.
Check T74.21XA with the rest of the claim: free scrubber7th character "A": initial encounter
The appropriate 7th character is to be added to each code from category T74
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Other codes that can never be billed with T74.21XA
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
T74.21XA is named in 8 Medicare coverage policies: 8 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56937Billing and Coding: Psychiatry and Psychology Services
- A57065Billing and Coding: Outpatient Psychiatry and Psychology Services
- A57130Billing and Coding: Psychiatric Codes
- A57780Billing and Coding: Psychological and Neuropsychological Tests
Code history
Unchanged in every release from FY2024 to FY2027.