T74 - Adult and child abuse, neglect and other maltreatment, confirmed

Coding Guidelines

The appropriate 7th character is to be added to each code from block Adult and child abuse, neglect and oth maltreat, confirmed (T74). Use the following options for the aplicable episode of care:

• A - initial encounter
• D - subsequent encounter
• S - sequela

Specific Coding for Adult and child abuse, neglect and oth maltreat, confirmed

Non-specific codes like T74 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10 codes with a higher level of specificity when coding for adult and child abuse, neglect and oth maltreat, confirmed:

Patient Education

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.

Most abused children suffer greater emotional than physical damage. An abused child may become depressed. He or she may withdraw, think of suicide or become violent. An older child may use drugs or alcohol, try to run away or abuse others.

Child abuse is a serious problem. If you suspect a child is being abused or neglected, call the police or your local child welfare agency.

Domestic Violence

What is domestic violence?

Domestic violence is a type of abuse. It can be the abuse of a spouse or partner, which is also known as intimate partner violence. Or it could be the abuse of a child, older relative, or other family member.

Domestic violence may include different types of abuse, such as:

• Physical violence that can lead to injuries such as bruises or fractures (broken bones)
• Sexual violence, including sexual assault
• Emotional abuse, which includes threats, name-calling, put-downs, and humiliation. It can also involve controlling behavior, such as telling the victim how to act or dress and not letting them see family or friends.
• Economic abuse, which involves controlling access to money
• Stalking, which is repeated, unwanted contact that causes fear or concern for the safety of the victim. This can include watching or following the victim. The stalker may send repeated, unwanted phone calls or texts.

Who is affected by domestic violence?

It is hard to know exactly how common domestic violence is, because it's often not reported.

But we do know that anyone can be affected by it. Domestic violence can happen to men or women of all different ages. It affects people with all levels of income and education.

What are the signs that someone is a victim of domestic violence?

If you think that a loved one might be the victim of domestic violence, learn about the different types of abuse and watch for these signs:

Does your friend or loved one:

• Have unexplained cuts or bruises?
• Avoid friends, family, and favorite activities?
• Make excuses for their partner's behavior?
• Look uncomfortable or fearful around their partner?

Does your friend or loved one's partner:

• Yell at or make fun of them?
• Try to control them by making all the decisions?
• Check up on them at work or school?
• Force them to do sexual things they don't want to do?
• Threaten to hurt himself or herself if the partner wants to break up?

What can I do if I am a victim of domestic violence?

Your safety is the most important concern. If you are in immediate danger, call 911.

If you are not in immediate danger, you can:

• Get medical care if you have been injured or sexually assaulted
• Call a helpline for free, anonymous help. You can contact the National Domestic Violence Hotline at 800-799-SAFE (7233) or 800-787-3224 (TTY).
• Find out where to get help in your community. Contact local organizations that can help you.
• Make a safety plan to leave. Domestic violence usually does not get better. Think about a safe place for you to go and all of the things that you will need when you leave.
• Save the evidence. Keep evidence of abuse, such as pictures of your injuries or threatening emails or texts. Make sure that it is in a safe place the abuser cannot access.
• Talk to someone you trust, such as a family member, a friend, a co-worker, or a spiritual leader
• Consider getting a restraining order to protect yourself

How can I help someone who is a victim of domestic violence?

Let your loved one know that being treated this way isn't healthy and that they are not to blame. You should:

• Call 911 if there is immediate danger
• Watch for the signs of abuse. Learn about the signs and keep track of the ones that you see.
• Find out about local resources. Get the addresses and phone numbers of some local resources in your community. Then you'll be able to share the information if the person is ready for it.
• Set up a time to talk. Make sure you can have your conversation in a safe, private place. Your loved one's partner may have access to his or her cell phone or computer, so be careful about sharing information over text or email.
• Be specific about why you are worried. Describe the behaviors that concern you. Be as specific as possible when explaining why you are worried.
• Plan for safety. If your loved one is ready to leave an abusive partner, help make a plan for getting out of the relationship as safely as possible. A domestic violence counselor can help with making a safety plan.
• Be patient and do not judge. You should talk about your concerns with your loved one, but you need to understand that they may not be ready to talk about it. Let them know that you're available to talk at any time, and that you will listen without judging them.

Elder Abuse

Many older people are victims of elder abuse. It is the mistreatment of an older person, usually by a caregiver. It can happen within the family. It can also happen in assisted living facilities or nursing homes.

The mistreatment may be:

• Physical, sexual, or emotional abuse
• Neglect or abandonment
• Financial abuse - stealing of money or belongings

Possible signs of elder abuse include unexplained bruises, burns, and injuries. There may also be bed sores and poor hygiene. The person may become withdrawn, agitated, and depressed. There may be a sudden change in the person's financial situation.

Elder abuse will not stop on its own. Someone else needs to step in and help. If you think that an older person is in urgent danger, call 911. Otherwise, contact adult protective services.

NIH: National Institute on Aging

Code History

• FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
• FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
• FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)