2026 ICD-10-CM Diagnosis Code T74.21XAAdult sexual abuse, confirmed, initial encounter
T74.21XA is a billable ICD-10-CM diagnosis code for adult sexual abuse, confirmed, initial encounter. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. 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 adult patients (age 15 through 124). In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under External cause codes: intent of injury, assault; External cause codes: other specified, classifiable and NEC; initial encounter; and Maltreatment/abuse.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for T74.21XA.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Abuse of disabled person
- Abusive sexual relationship
- Abusive sexual relationship with partner
- Adult victim of non-domestic sexual abuse
- Adult victim of sexual abuse
- Adult victim of sexual abuse during military service
- Attempted anal rape of female
- Attempted male rape
- Attempted rape of female
- Attempted vaginal rape of female
- Domestic abuse
- Domestic abuse of adult
- Domestic sexual abuse
- Domestic sexual abuse of adult
- Elder abuse
- Elder sexual abuse
- Elderly person maltreatment
- Forcible intercourse
- Forcible sexual assault
- Homicide and assault by fight, brawl and rape
- Homosexual forcible assault
- Incapacitated sexual assault
- Intrafamilial sexual abuse
- Overt sexual harassment by male
- Rape - assault
- Rape with vaginal intercourse
- Recipient of obscene telephone call
- Serious reportable event associated with criminal activity
- Sexual abuse
- Sexual abuse of adult
- Sexual abuse of disabled person
- Sexual aggression
- Sexual assault
- Sexual assault of female with touching of breast through clothing
- Sexual assault of female with touching of sexual parts
- Sexual assault of female with touching of unclothed breast
- Sexual assault of female with touching of vulva through clothing
- Sexual assault on a patient within or on the grounds of the healthcare facility
- Sexual assault on female with touching of unclothed vulva
- Sexual assault on male with anal penetration by penis
- Sexual assault on male with touching of sexual organs
- Sexual assault on male with touching of sexual organs through clothing
- Sexual assault on male with touching of unclothed sexual organs
- Sexual assault with anal penetration by penis
- Sexual assault with digital penetration of anus
- Sexual assault with digital penetration of vagina
- Sexual assault with oral penetration by penis
- Sexual assault with penetration of anus with foreign body
- Sexual assault with penetration of vagina with foreign body
- Sexual battery
- Sexual harassment
- Sexual harassment by female
- Sexual harassment by male
- Statutory rape
- Victim of abusive sexual relationship
- Victim of abusive sexual relationship with husband
- Victim of abusive sexual relationship with partner
- Victim of abusive sexual relationship with wife
- Victim of forced sexual activity
- Victim of incest
- Victim of intimate partner abuse
- Victim of physical assault
- Victim of rape
- Victim of rape as adult
- Victim of sexual abuse by intimate partner
- Victim of sexual aggression
- Victim of sexual assault by intimate partner
- Victim of sexual assault by member of household
- Victim of sexual harassment
- Victim of statutory rape
- Witness of indecent exposure
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
Elder Abuse
emotional, nutritional, financial, or physical maltreatment, exploitation, or abandonment of the older person generally by family members or by institutional personnel.Sexual Harassment
a form of discrimination in the workplace which violates the civil rights act of 1964. offensive sexual conduct may include unwelcome advances, comments, touching, questions about marital status and sex practices, etc. both men and women may be aggressors or victims. (slee and slee, health care terms, 2d ed, p.404). while civil rights legislation deals with sexual harassment in the workplace, the behavior is not restricted to this; it may take place outside the work environment: in schools, athletics, and other social milieus and activities.
Patient EducationClinical
Sexual Assault
Sexual assault is any kind of sexual activity, contact, or experience that happens without your consent. That means the sexual activity happens even though you don't agree to it.
The full article covers:
- What is sexual assault?
- What does sexual assault include?
- What does "consent" mean?
- Who commits sexual assault?
- What are the possible health effects from sexual assault?
- What can I do if I'm a victim of sexual assault?
- Can sexual assault be prevented?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert T74.21XA to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About T74.21XAOverview
Is T74.21XA (Adult sexual abuse, confirmed) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report adult sexual abuse, confirmed, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character A in T74.21XA mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for adult sexual abuse, confirmed, such as an emergency visit or first evaluation.
What MS-DRG does T74.21XA group to?
When adult sexual abuse, confirmed, initial encounter 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 T74.21XA be reported for?
The Medicare Code Editor checks adult sexual abuse, confirmed, initial encounter against patient demographics: this code is intended for adult patients (age 15 through 124). Claims outside these limits are flagged as inconsistent.
What is the ICD-9 equivalent of T74.21XA?
Under the General Equivalence Mappings, adult sexual abuse, confirmed, initial encounter converts to ICD-9-CM 995.83 (adult sexual abuse). The mapping is approximate, so confirm the match fits the documentation.
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.
