Is T76 a billable ICD-10-CM code?

No. T76 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does T76 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 T76?

T76 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

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

These codes carry an Excludes1 note pointing at T76. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading T76 alone.

Z91.410Personal history of adult physical and sexual abuse
Z91.412Personal history of adult neglect
T74Adult and child abuse, neglect and other maltreatment, confirmed
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

Risk adjustment

T76 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.

Code to one of these instead T76

8 child codes. Green means billable.

Questions about T76

Is T76 a billable ICD-10-CM code?: No. T76 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does T76 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 T76?: T76 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.