Adult and child abuse, neglect and other maltreatment, suspected
In Other and unspecified effects of external causes (T66-T78), chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes
48 billable codes under T76: 13 are a CC; none map to an HCC.A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment.
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Instructional notes
Excludes1: not coded here, use a different code
- 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 second code for this, listed after this one
- code, if applicable, to identify any associated current injury
Also applies, from Other and unspecified effects of external causes (T66-T78)
These notes sit on T66-T78 and apply to every code under it, including T76.
Code also: add a code for this too, order depends on the encounter
- if applicable, place of occurrence, such as:
- highway rest stop (Y92.523)
- school (private) (public) (state) as the place of occurrence of the external cause (Y92.21-)
- service areas as the place of occurrence of the external cause (Y92.52-)
- single-family non-institutional (private) house as the place of occurrence of the external cause (Y92.01-)
- transport vehicle as the place of occurrence of the external cause (Y92.81-)
Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
- Section I.C.19.f Adult and child abuse, neglect and other maltreatment (page 85), covers T76
Sequence T74 (confirmed) or T76 (suspected) first, then mental health or injury codes. Add assault (X92-Y09) and perpetrator (Y07) codes only for confirmed cases; use Z04 codes when suspected abuse is ruled out.
Other Chapter 19 topics:
- Application of 7th Characters in Chapter 19 (page 77)
- Coding of Injuries (page 78)
- Coding of Traumatic Fractures (page 79)
- Coding of Burns and Corrosions (page 80)
- Adverse Effects, Poisoning, Underdosing and Toxic Effects (page 82)
- Complications of care (page 85)
All codes under T76
T76 can't be used on a claim. Pick a billable code below; grey headings group them.
- T76.0Neglect or abandonment, suspected
- T76.01Adult neglect or abandonment, suspected
- T76.01XAAdult neglect or abandonment, suspected, initial encounter
- T76.01XDAdult neglect or abandonment, suspected, subsequent encounter
- T76.01XSAdult neglect or abandonment, suspected, sequela
- T76.02Child neglect or abandonment, suspected
- T76.02XAChild neglect or abandonment, suspected, initial encounter
- T76.02XDChild neglect or abandonment, suspected, subsequent encounter
- T76.02XSChild neglect or abandonment, suspected, sequela
- T76.1Physical abuse, suspected
- T76.11Adult physical abuse, suspected
- T76.11XAAdult physical abuse, suspected, initial encounter
- T76.11XDAdult physical abuse, suspected, subsequent encounter
- T76.11XSAdult physical abuse, suspected, sequela
- T76.12Child physical abuse, suspected
- T76.12XAChild physical abuse, suspected, initial encounter
- T76.12XDChild physical abuse, suspected, subsequent encounter
- T76.12XSChild physical abuse, suspected, sequela
- T76.2Sexual abuse, suspected
- T76.21Adult sexual abuse, suspected
- T76.21XAAdult sexual abuse, suspected, initial encounter
- T76.21XDAdult sexual abuse, suspected, subsequent encounter
- T76.21XSAdult sexual abuse, suspected, sequela
- T76.22Child sexual abuse, suspected
- T76.22XAChild sexual abuse, suspected, initial encounter
- T76.22XDChild sexual abuse, suspected, subsequent encounter
- T76.22XSChild sexual abuse, suspected, sequela
- T76.3Psychological abuse, suspected
- T76.31Adult psychological abuse, suspected
- T76.31XAAdult psychological abuse, suspected, initial encounter
- T76.31XDAdult psychological abuse, suspected, subsequent encounter
- T76.31XSAdult psychological abuse, suspected, sequela
- T76.32Child psychological abuse, suspected
- T76.32XAChild psychological abuse, suspected, initial encounter
- T76.32XDChild psychological abuse, suspected, subsequent encounter
- T76.32XSChild psychological abuse, suspected, sequela
- T76.5Forced sexual exploitation, suspected
- T76.51Adult forced sexual exploitation, suspected
- T76.51XAAdult forced sexual exploitation, suspected, initial encounter
- T76.51XDAdult forced sexual exploitation, suspected, subsequent encounter
- T76.51XSAdult forced sexual exploitation, suspected, sequela
- T76.52Child sexual exploitation, suspected
- T76.52XAChild sexual exploitation, suspected, initial encounter
- T76.52XDChild sexual exploitation, suspected, subsequent encounter
- T76.52XSChild sexual exploitation, suspected, sequela
- T76.6Forced labor exploitation, suspected
- T76.61Adult forced labor exploitation, suspected
- T76.61XAAdult forced labor exploitation, suspected, initial encounter
- T76.61XDAdult forced labor exploitation, suspected, subsequent encounter
- T76.61XSAdult forced labor exploitation, suspected, sequela
- T76.62Child forced labor exploitation, suspected
- T76.62XAChild forced labor exploitation, suspected, initial encounter
- T76.62XDChild forced labor exploitation, suspected, subsequent encounter
- T76.62XSChild forced labor exploitation, suspected, sequela
- T76.9Unspecified maltreatment, suspected
- T76.91Unspecified adult maltreatment, suspected
- T76.91XAUnspecified adult maltreatment, suspected, initial encounter
- T76.91XDUnspecified adult maltreatment, suspected, subsequent encounter
- T76.91XSUnspecified adult maltreatment, suspected, sequela
- T76.92Unspecified child maltreatment, suspected
- T76.92XAUnspecified child maltreatment, suspected, initial encounter
- T76.92XDUnspecified child maltreatment, suspected, subsequent encounter
- T76.92XSUnspecified child maltreatment, suspected, sequela
- T76.AFinancial abuse, suspected
- T76.A1Adult financial abuse, suspected
- T76.A1XAAdult financial abuse, suspected, initial encounter
- T76.A1XDAdult financial abuse, suspected, subsequent encounter
- T76.A1XSAdult financial abuse, suspected, sequela
- T76.A2Child financial abuse, suspected
- T76.A2XAChild financial abuse, suspected, initial encounter
- T76.A2XDChild financial abuse, suspected, subsequent encounter
- T76.A2XSChild financial abuse, suspected, sequela
T76 MS-DRGs
As the principal diagnosis, the billable codes under T76 group to MS-DRG 922, 923, 949, or 950 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
- DRG 922 Other Injury, Poisoning and Toxic Effect Diagnoses with MCC (32 of 48 codes)
- DRG 923 Other Injury, Poisoning and Toxic Effect Diagnoses without MCC (32 of 48 codes)
- DRG 949 Aftercare with CC/MCC (16 of 48 codes)
- DRG 950 Aftercare without CC/MCC (16 of 48 codes)
Other codes that refer to T76
Notes on these codes point to T76.
- O9A.2 Includes: Conditions in S00-T88, except T74 and T76
- T74 Excludes1: adult and child maltreatment, suspected (T76.-)
- Z04.71 Excludes1: suspected case of adult physical abuse, not ruled out (T76.-)
- Z04.72 Excludes1: suspected case of child physical abuse, not ruled out (T76.-)
- Z63 Excludes2: maltreatment syndrome (T74.-, T76)
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Child Abuse
Child abuse is doing something or failing to do something that results in harm to a child or puts a child at risk of harm. Child abuse can be physical, sexual or emotional. Neglect, or not providing for a child's needs, is also a form of abuse.
Read more about child abuse on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.