T76
T76: Adult and child abuse, neglect and other maltreatment, suspected
Non-billable headerICD-10-CM
T76 is a non-billable header ICD-10-CM code for adult and child abuse, neglect and other maltreatment, suspected. 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 T76
- 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.
- adult and child maltreatment, confirmed (T74.-)
- suspected abuse and maltreatment in pregnancy (O9A.3-, O9A.4-, O9A.5-)
- suspected adult physical abuse, ruled out (Z04.71)
- suspected adult sexual abuse, ruled out (Z04.41)
- suspected child physical abuse, ruled out (Z04.72)
- suspected child sexual abuse, ruled out (Z04.42)
Use additional code
Add a secondary code to capture the detail described below.
- code, if applicable, to identify any associated current injury
Other codes that can never be billed with T76
Their own Excludes1 notes name this code, so the conflict is not listed above.
- Z91.410Personal history of adult physical and sexual abuse
- Z91.412Personal history of adult neglect
- 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
- Z62.819Personal history of unspecified abuse in childhood
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Code history
Unchanged in every release from FY2024 to FY2027.
Code to one of these instead T76
8 child codes. Green means billable.