T76.2 — Sexual abuse, suspected
T76.2 is a non-billable header ICD-10-CM code for sexual abuse, 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.
- alleged abuse, ruled out (Z04.7)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Rape, suspected
Other codes that can never be billed with T76.2
These codes carry an Excludes1 note pointing at T76.2. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading T76.2 alone.
- Z62.810Personal history of physical and sexual abuse in childhood
Risk adjustment
T76.2 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 T76.2
2 child codes. Green means billable.
Related codes at this level
Codes that share T76. If T76.2 is not quite right, the correct code is usually one of these.
Questions about T76.2
- Is T76.2 a billable ICD-10-CM code?
- No. T76.2 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does T76.2 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 T76.2?
- T76.2 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.