Is T74.4XXS a billable ICD-10-CM code?

Yes. T74.4XXS is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does T74.4XXS 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 T74.4XXS?

T74.4XXS carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above T74.4XXS (T74) and apply to it just the same.

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.

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

These are not written on T74.4XXS, but they bind it: a note on a category applies to every code beneath it. Billing T74.4XXS with anything listed here is a denial.

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

These codes carry an Excludes1 note pointing at T74.4XXS. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading T74.4XXS alone.

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

T74.4XXS 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

T74.4XXS is named in 8 Medicare coverage policies — 8 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
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)

Code history

T74.4XXS has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share T74.4. If T74.4XXS is not quite right, the correct code is usually one of these.

Questions about T74.4XXS

Is T74.4XXS a billable ICD-10-CM code?: Yes. T74.4XXS is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does T74.4XXS 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 T74.4XXS?: T74.4XXS carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above T74.4XXS (T74) and apply to it just the same.