T74.4XXS

T74.4XXS: Shaken infant syndrome, sequela

Billable / specific codeICD-10-CMPOA exempt

T74.4XXS is a billable, specific ICD-10-CM code for shaken infant syndrome, sequela. It is valid for submission on a claim.

Check T74.4XXS with the rest of the claim: free scrubber

7th character "S": sequela

The appropriate 7th character is to be added to each code from category T74

A: initial encounter
D: subsequent encounter
S: sequela

Excludes1 inherited from the categories above T74.4XXS

A category’s note binds every code beneath it.

Written on T74: Adult and child abuse, neglect and other maltreatment, confirmed

abuse and maltreatment in pregnancy (O9A.3-, O9A.4-, O9A.5-)
adult and child maltreatment, suspected (T76.-)

Other codes that can never be billed with T74.4XXS

Their own Excludes1 notes name this code, so the conflict is not listed above.

Z04.71Encounter for examination and observation following alleged adult physical abuse
Z04.72Encounter for examination and observation following alleged child physical abuse
T76Adult and child abuse, neglect and other maltreatment, suspected

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

T74.4XXS is named in 6 Medicare coverage policies: 6 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

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)
A57068Billing and Coding: Ocular Photography - External

Code history

Unchanged in every release from FY2024 to FY2027.