2024 ICD-10-CM Diagnosis Code T74.91XA

Unspecified adult maltreatment, confirmed, initial encounter

ICD-10-CM Code:
T74.91XA
ICD-10 Code for:
Unspecified adult maltreatment, 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)

T74.91XA is a billable diagnosis code used to specify a medical diagnosis of unspecified adult maltreatment, 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 T74.91XA is applicable to adult patients aged 15 through 124 years inclusive. It is clinically and virtually impossible to use this code on a patient outside the stated age range.

T74.91XA is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like unspecified adult maltreatment 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.

Unspecified diagnosis codes like T74.91XA are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.

Approximate Synonyms

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

  • Abuse
  • Abuse by relative of victim
  • Abuse by relative of victim
  • Abuse by sibling
  • Abuse by unrelated caregiver
  • Abuse of disabled person
  • Abuse of partner
  • Abusive caretaking
  • Adult abuse
  • Adult victim of abuse
  • Domestic abuse
  • Domestic abuse
  • Domestic abuse
  • Domestic abuse of adult
  • Elderly person maltreatment
  • Non-accidental injury
  • Non-accidental injury to adult
  • Victim of abuse
  • Victim of abuse with enhanced social monitoring
  • Victim of abuse with limited perpetrator access to victim
  • Victim of elder abuse
  • Victim of elder abuse
  • Victim of elder abuse
  • Victim of elder abuse by related caregiver
  • Victim of elder abuse by unrelated caregiver
  • Victim of excessive discipline
  • Victim of harsh discipline
  • Victim of institutional abuse
  • Victim of intimate partner abuse
  • Victim of violent environment

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.

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

Replaced Code

This code was replaced in the 2024 ICD-10-CM 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, 2023. This code was replaced for the FY 2024 (October 1, 2023 - September 30, 2024).


  • T74.A1XA - Adult financial abuse, confirmed, initial encounter

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:

  • Adult diagnoses - The Medicare Code Editor detects inconsistencies in adult cases by checking a patient's age and any diagnosis on the patient's record. The adult code edits apply to patients age range is 15–124 years inclusive (e.g., senile delirium, mature cataract).

Convert T74.91XA to ICD-9-CM

  • ICD-9-CM Code: 995.80 - Adult maltreatment NOS
    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.

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.