T76.91XA
T76.91XA — Unspecified adult maltreatment, suspected, initial encounter
Billable / specific codeICD-10-CM
T76.91XA is a billable, specific ICD-10-CM code for unspecified adult maltreatment, 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
T76.91XA 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
T76.91XA is named in 2 Medicare coverage policies — 2 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
- A57780Billing and Coding: Psychological and Neuropsychological Tests
Related codes at this level
Codes that share T76.91. If T76.91XA is not quite right, the correct code is usually one of these.
Questions about T76.91XA
- Is T76.91XA a billable ICD-10-CM code?
- Yes. T76.91XA is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does T76.91XA 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).