2024 ICD-10-CM Diagnosis Code T74.12XA

Child physical abuse, confirmed, initial encounter

ICD-10-CM Code:
T74.12XA
ICD-10 Code for:
Child physical abuse, confirmed, initial encounter
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Not chronic
Code Navigator:

Code Classification

  • Injury, poisoning and certain other consequences of external causes
    (S00–T88)
    • Other and unspecified effects of external causes
      (T66-T78)
      • Adult and child abuse, neglect and other maltreatment, confirmed
        (T74)

T74.12XA is a billable diagnosis code used to specify a medical diagnosis of child physical abuse, confirmed, initial encounter. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

The code T74.12XA is applicable for patients aged 0 through 17 years inclusive. It is clinically and virtually impossible to use this code on a patient outside the stated age range.

T74.12XA is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like child physical abuse confirmed. According to ICD-10-CM Guidelines an "initial encounter" doesn't necessarily means "initial visit". The 7th character should be used when the patient is undergoing active treatment regardless if new or different providers saw the patient over the course of a treatment. The appropriate 7th character codes should also be used even if the patient delayed seeking treatment for a condition.

Approximate 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
  • Battered baby
  • Battered baby AND/OR child syndrome
  • Child abuse
  • Child affected by Munchausen's by proxy
  • Domestic physical abuse
  • Non-accidental injury
  • Physical abuse
  • Physical abuse of disabled person
  • Physical child abuse
  • Physical injury due to physical abuse
  • Victim of child abuse
  • Victim of child abuse
  • Victim of child abuse
  • Victim of homosexual aggression
  • Victim of intimate partner abuse
  • Victim of physical abuse
  • Victim of physical abuse by intimate partner
  • Victim of physical assault
  • Victim of trampling

Clinical Classification

Clinical CategoryCCSR Category CodeInpatient Default CCSROutpatient Default CCSR
External cause codes: intent of injury, assaultEXT022N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.
External cause codes: other specified, classifiable and NEC; initial encounterEXT018N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.
Maltreatment/abuseINJ032Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

Clinical Information

  • Adult Survivors of Child Abuse

    persons who were child victims of violence and abuse including physical, sexual, or emotional maltreatment.
  • Child Abuse

    abuse of children in a family, institutional, or other setting. (apa, thesaurus of psychological index terms, 1994)
  • Child Abuse, Sexual

    sexual maltreatment of the child or minor.
  • Physical Abuse

    violence inflicted on an individual through physical contact.

Coding Guidelines

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

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

Code Edits

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

  • Pediatric diagnoses - The Medicare Code Editor detects inconsistencies in pediatric cases by checking a patient's age and any diagnosis on the patient's record. The pediatric code edits apply to patients age range is 0–17 years inclusive (e.g., Reye's syndrome, routine child health exam).

Convert T74.12XA to ICD-9-CM

  • ICD-9-CM Code: 995.54 - Child physical abuse
    Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

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.


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Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • 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. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.