2026 ICD-10-CM Diagnosis Code T74.51XAAdult forced sexual exploitation, confirmed, initial encounter

ICD-10-CM Codes›S00–T88›T66-T78›T74

ICD-10-CM T74.51XA
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

T74.51XA is a billable ICD-10-CM diagnosis code for adult forced sexual exploitation, 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). Coders also document this condition as victim of exploitation. 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
T74.51XA
Billable Status
Yes — Valid for Submission
Code Describes
Adult forced sexual exploitation, confirmed, initial encounter
Short Description
Adult forced sexual exploitation, confirmed, init
Parent Code
T74.51
Adult forced sexual exploitation, 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 CodeT74.51XAAdult forced sexual exploitation, confirmed, initial encounter

Code EditsBilling

Medicare Code Editor checks that affect claim validity for T74.51XA.

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.

  • Victim of exploitation
  • Victim of forced marriage

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.

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.

Code History & ChangesHistory

Replacement T74.51XA replaces the following previously assigned code(s):

  • T74.21XA - Adult sexual abuse, confirmed, initial encounter
FY 2019AddedAdded to the ICD-10-CM code setEffective October 1, 2018.
FY 2020–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About T74.51XAOverview

Is T74.51XA (Adult forced sexual exploitation, confirmed) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report adult forced sexual exploitation, confirmed, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character A in T74.51XA mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for adult forced sexual exploitation, confirmed, such as an emergency visit or first evaluation.

What MS-DRG does T74.51XA group to?

When adult forced sexual exploitation, 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 T74.51XA be reported for?

The Medicare Code Editor checks adult forced sexual exploitation, 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.

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.