T76.12XS
T76.12XS — Child physical abuse, suspected, sequela
Billable / specific codeICD-10-CMPOA exempt
T76.12XS is a billable, specific ICD-10-CM code for child physical abuse, suspected, 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 T76
- A
- initial encounter
- D
- subsequent encounter
- S
- sequela
Risk adjustment
T76.12XS 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
T76.12XS is named in 9 Medicare coverage policies — 9 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)
Related codes at this level
Codes that share T76.12. If T76.12XS is not quite right, the correct code is usually one of these.
Questions about T76.12XS
- Is T76.12XS a billable ICD-10-CM code?
- Yes. T76.12XS is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T76.12XS 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).