2026 ICD-10-CM Diagnosis Code T74.12XSChild physical abuse, confirmed, sequela
T74.12XS is a billable ICD-10-CM diagnosis code for child physical abuse, confirmed, sequela. The 7th character S marks it as a sequela code, which reports a problem that remains after the original condition has resolved. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 922 through 923. The code is restricted by the Medicare Code Editor to pediatric patients (age 0 through 17) and exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Effect of other external causes, sequela.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for T74.12XS.
Present on Admission (POA)Billing
T74.12XS is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Abuse of disabled person
- Battered baby
- Battered baby AND/OR child syndrome
- Child affected by Munchausen's by proxy
- Domestic physical abuse
- Late effect of domestic violence
- Late effects of assault
- Non-accidental injury
- Physical abuse
- Physical abuse of disabled person
- Physical child abuse
- Physical injury due to physical 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
Coding GuidelinesGuidance
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 applicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2026, published by CMS and the National Center for Health Statistics.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Physical Abuse
violence inflicted on an individual through physical contact.
Patient EducationClinical
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 the full article at MedlinePlus
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Convert T74.12XS to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About T74.12XSOverview
Is T74.12XS (Child physical abuse, confirmed) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report child physical abuse, confirmed, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in T74.12XS mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the child physical abuse, confirmed itself has resolved, not the original event.
What MS-DRG does T74.12XS group to?
When child physical abuse, confirmed, sequela is the principal diagnosis on an inpatient stay, it groups to MS-DRG 922, 923, with relative weights from 1.0177 to 1.7494 depending on complications. Higher weights mean higher Medicare reimbursement.
Who can T74.12XS be reported for?
The Medicare Code Editor checks child physical abuse, confirmed, sequela against patient demographics: this code is intended for pediatric patients (age 0 through 17). Claims outside these limits are flagged as inconsistent.
Is T74.12XS exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for child physical abuse, confirmed, sequela on inpatient claims.
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.
