MCMCB Pro
T76.22XA

T76.22XAChild sexual abuse, suspected, initial encounter

Billable / specific codeICD-10-CM

T76.22XA is a billable, specific ICD-10-CM code for child sexual abuse, suspected, initial encounter. It is valid for submission on a claim.

7th character "A" — initial encounter

The appropriate 7th character is to be added to each code from category T76

A
initial encounter
D
subsequent encounter
S
sequela

Risk adjustment

T76.22XA 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

T76.22XA is named in 6 Medicare coverage policies 6 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

  • A56726Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
  • A56937Billing and Coding: Psychiatry and Psychology Services
  • A57065Billing and Coding: Outpatient Psychiatry and Psychology Services
  • A57071Billing and Coding: Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)

Related codes at this level

Codes that share T76.22. If T76.22XA is not quite right, the correct code is usually one of these.

Questions about T76.22XA

Is T76.22XA a billable ICD-10-CM code?
Yes. T76.22XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does T76.22XA 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).
ICD-10-CMFY2026-Apr· effective April 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release — see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.