2026 ICD-10-CM Diagnosis Code T74.91XAUnspecified adult maltreatment, confirmed, initial encounter
T74.91XA is a billable ICD-10-CM diagnosis code for unspecified adult maltreatment, 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 T74.91XA.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Abuse
- Abuse by relative of victim
- Abuse by sibling
- Abuse by unrelated caregiver
- Abuse of disabled person
- Abusive caretaking
- Adult abuse
- Adult victim of abuse
- Domestic abuse
- Domestic abuse of adult
- Elder abuse
- Elderly person maltreatment
- Intimate partner abuse
- 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 domestic violence
- 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
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.
Convert T74.91XA to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About T74.91XAOverview
Is T74.91XA (Unspecified adult maltreatment, confirmed) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report unspecified adult maltreatment, confirmed, initial encounter on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character A in T74.91XA mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for unspecified adult maltreatment, confirmed, such as an emergency visit or first evaluation.
What MS-DRG does T74.91XA group to?
When unspecified adult maltreatment, 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 T74.91XA be reported for?
The Medicare Code Editor checks unspecified adult maltreatment, 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 T74.91XA?
Under the General Equivalence Mappings, unspecified adult maltreatment, confirmed, initial encounter converts to ICD-9-CM 995.80 (adult maltreatment NOS). 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.
