ICD-10 Code T74.11XS

Adult physical abuse, confirmed, sequela

Version 2019 Replaced Code Billable Code Adult Diagnoses POA Exempt

Valid for Submission

T74.11XS is a billable code used to specify a medical diagnosis of adult physical abuse, confirmed, sequela. The code is valid for the year 2020 for the submission of HIPAA-covered transactions.

ICD-10: T74.11XS
Short Description:Adult physical abuse, confirmed, sequela
Long Description:Adult physical abuse, confirmed, sequela

Replaced Code

This code was replaced in the 2020 ICD-10 code set with the code(s) listed below. The National Center for Health Statistics (NCHS) has published an update to the ICD-10-CM diagnosis codes which became effective October 1, 2019. This code was replaced for the FY 2020 (October 1, 2019 - September 30, 2020).

  • T74.61XS - Adult forced labor exploitation, confirmed, sequela

Code Classification

  • Injury, poisoning and certain other consequences of external causes (S00–T98)
    • Other and unspecified effects of external causes (T66-T78)
      • Adult and child abuse, neglect and oth maltreat, confirmed (T74)

Code History

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

Information for Medical Professionals

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:

  • Adult diagnoses - Adult. Age range is 15–124 years inclusive (e.g., senile delirium, mature cataract).

Diagnostic Related Groups

The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). The diagnosis code T74.11XS is grouped in the following groups for version MS-DRG V37.0 applicable from 10/01/2020 through 09/30/2020.

  • 922 - OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC
  • 923 - OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC

Convert T74.11XS to ICD-9

The following crosswalk between ICD-10 to ICD-9 is based based on the General Equivalence Mappings (GEMS) information:

  • 909.9 - Late eff exter cause NEC (Approximate Flag)

Present on Admission (POA)

T74.11XS is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement.

CMS POA Indicator Options and Definitions
POA Indicator CodePOA Reason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Abuse of disabled person
  • Adult victim of non-domestic physical abuse
  • Adult victim of physical abuse
  • Adult victim of physical abuse
  • Adult victim of physical abuse by female partner
  • Adult victim of physical abuse by male partner
  • Battered husband
  • Battered spouse syndrome
  • Battered wife
  • Battered woman syndrome
  • Domestic abuse
  • Domestic physical abuse
  • Domestic violence
  • Elderly person maltreatment
  • Late effect of domestic violence
  • Late effects of assault
  • Non-accidental injury
  • Non-domestic physical abuse of adult
  • Physical abuse
  • Physical abuse
  • Physical abuse
  • Physical abuse
  • Physical abuse
  • Physical abuse of adult
  • Physical abuse of adult
  • Physical abuse of disabled person
  • Physical abuse of elderly person
  • Physical injury due to physical abuse
  • Victim of elder abuse
  • Victim of elder physical abuse
  • Victim of homosexual aggression
  • Victim of physical abuse
  • Victim of physical assault
  • Victim of trampling

ICD-10 Footnotes

General Equivalence Map Definitions
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

  • Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
  • No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
  • Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.