2027 ICD-10-CM Diagnosis Code T74.21XAAdult sexual abuse, confirmed, initial encounter

ICD-10-CM Codes›S00–T88›T66-T78›T74

ICD-10-CM T74.21XA
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

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 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 922 through 923. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 53 closely related codes. 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

ICD-10-CM Code
T74.21XA
Billable Status
Yes — Valid for Submission
Code Describes
Adult sexual abuse, confirmed, initial encounter
Short Description
Adult sexual abuse, confirmed, initial encounter
Same as the full description in the CMS dataset.
Parent Code
T74.21
Adult sexual abuse, confirmed

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionT66-T78Other and unspecified effects of external causes
CategoryT74Adult and child abuse, neglect and other maltreatment, confirmed
This CodeT74.21XAAdult sexual abuse, confirmed, initial encounter

Code EditsBilling

Medicare Code Editor checks that affect claim validity for T74.21XA.

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).

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
  • Elderly victim of maltreatment
  • Forcible intercourse
  • Forcible sexual assault
  • Homicide and assault by fight, brawl and rape
  • Homosexual forcible assault
  • Incapacitated sexual assault
  • Intimate partner abuse
  • Intimate partner sexual abuse
  • 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 wife
  • Victim of domestic sexual abuse
  • Victim of elder abuse
  • Victim of elder sexual abuse
  • 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 abuse during military service
  • Victim of sexual aggression
  • Victim of sexual assault
  • 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 2027, published by CMS and the National Center for Health Statistics.

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to T74.21XA: its own notes plus those printed at T74, block T66-T78, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From T74 Adult and child abuse, neglect and other maltreatment, confirmed applies to 51 codes

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From T74 Adult and child abuse, neglect and other maltreatment, confirmed applies to 51 codes
  • code, if applicable, to identify any associated current injury
  • external cause code to identify perpetrator, if known (Y07.-)
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • code to identify any retained foreign body, if applicable (Z18.-)

Code Also

A second code may be needed to fully describe the condition; the note gives no sequencing direction.

From Block T66-T78 Other and unspecified effects of external causes applies to 456 codes
  • if applicable, place of occurrence, such as:
  • highway rest stop (Y92.523)
  • school (private) (public) (state) as the place of occurrence of the external cause (Y92.21-)
  • service areas as the place of occurrence of the external cause (Y92.52-)
  • single-family non-institutional (private) house as the place of occurrence of the external cause (Y92.01-)
  • transport vehicle as the place of occurrence of the external cause (Y92.81-)

Notes

General instructions on how these codes are used.

From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
  • The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.

7th Character

Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.

From T74 Adult and child abuse, neglect and other maltreatment, confirmed applies to 51 codes
  • The appropriate 7th character is to be added to each code from category T74
Values for category T74 Encounter: Initial, Subsequent, Sequela
  • Ainitial encounter this code
  • Dsubsequent encounter
  • Ssequela

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name T74.21XA, its category, or a range that includes it.

Applicable To 2

These notes mention T74.21XA.

  • O9A.2 Injury, poisoning and certain other consequences of external causes complicating pregnancy, childbirth and the puerperium
    Conditions in S00-T88, except T74 and T76 names T74, which includes this code
  • O9A.4 Sexual abuse complicating pregnancy, childbirth and the puerperium
    Conditions in T74.21 or T76.21 names T74.21, which includes this code

Excludes1 4

These codes carry an Excludes1 note naming T74.21XA: they are not reported together with it, unless the two conditions are unrelated.

  • T76 Adult and child abuse, neglect and other maltreatment, suspected
    adult and child maltreatment, confirmed (T74.-) names T74.-, which includes this code
  • Z04.71 Encounter for examination and observation following alleged adult physical abuse
    confirmed case of adult physical abuse (T74.-) names T74.-, which includes this code
  • Z04.72 Encounter for examination and observation following alleged child physical abuse
    confirmed case of child physical abuse (T74.-) names T74.-, which includes this code
  • Z91.410 Personal history of adult physical and sexual abuse
    current adult sexual abuse (T74.21, T76.11) names T74.21, which includes this code

Excludes2 5

These codes carry an Excludes2 note naming T74.21XA: its condition is not part of those codes, and both may be reported when the patient has both.

  • F94.1 Reactive attachment disorder of childhood
    maltreatment syndromes (T74.-) names T74.-, which includes this code
  • T74.1 Physical abuse, confirmed
    sexual abuse (T74.2-) names T74.2-, which includes this code
  • Z62 Problems related to upbringing
    maltreatment syndrome (T74.-) names T74.-, which includes this code
  • Z62.815 Personal history of intimate partner abuse in childhood
    adult and child abuse, neglect and other maltreatment, confirmed (T74.-) names T74.-, which includes this code
  • Z63 Other problems related to primary support group, including family circumstances
    maltreatment syndrome (T74.-, T76) names T74.-, which includes this code

Notes 1

These notes mention T74.21XA.

  • Y07 Perpetrator of assault, maltreatment and neglect
    Codes from this category are for use only in cases of confirmed abuse (T74.-) names T74.-, which includes this code

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index; each main term links to its index entry.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR EXT022
External cause codes: intent of injury, assault
Default principal diagnosis: inpatient No · outpatient No
CCSR EXT018
External cause codes: other specified, classifiable and NEC; initial encounter
Default principal diagnosis: inpatient No · outpatient No
CCSR INJ032
Maltreatment/abuse
Default principal diagnosis: inpatient Yes · outpatient Yes

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.

ICD-9-CM
995.83 Adult sexual abuse
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About T74.21XAOverview

What is the ICD-10 code for adult sexual abuse, confirmed, initial encounter?

The ICD-10-CM code for adult sexual abuse, confirmed, initial encounter is T74.21XA (sometimes written as T7421XA). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

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, 2026 through September 30, 2027.

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 923, 922, with relative weights from 0.9980 to 1.6248 depending on complications. Higher weights mean higher Medicare reimbursement.

Is T74.21XA a CC or MCC?

CMS lists T74.21XA as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 53 closely related codes in its exclusion list.