2027 ICD-10-CM Diagnosis Code T74.91XSUnspecified adult maltreatment, confirmed, sequela
T74.91XS is a billable ICD-10-CM diagnosis code for unspecified adult maltreatment, 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 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 922 through 923. The code is restricted by the Medicare Code Editor to adult patients (age 15 through 124) 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 T74.91XS.
Present on Admission (POA)Billing
T74.91XS is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Other and unspecified effects of external causes (T66-T78).
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
- Elderly victim of 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 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 T74.91XS: 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.
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.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code, if applicable, to identify any associated current injury
- external cause code to identify perpetrator, if known (Y07.-)
- 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.
- 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.
- 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.
- The appropriate 7th character is to be added to each code from category T74
- Ainitial encounter
- Dsubsequent encounter
- Ssequela this code
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name T74.91XS, its category, or a range that includes it.
Applicable To 1
These notes mention T74.91XS.
Excludes1 3
These codes carry an Excludes1 note naming T74.91XS: they are not reported together with it, unless the two conditions are unrelated.
- T76 Adult and child abuse, neglect and other maltreatment, suspectedadult and child maltreatment, confirmed (T74.-) names T74.-, which includes this code
- Z04.71 Encounter for examination and observation following alleged adult physical abuseconfirmed case of adult physical abuse (T74.-) names T74.-, which includes this code
- Z04.72 Encounter for examination and observation following alleged child physical abuseconfirmed case of child physical abuse (T74.-) names T74.-, which includes this code
Excludes2 4
These codes carry an Excludes2 note naming T74.91XS: its condition is not part of those codes, and both may be reported when the patient has both.
- F94.1 Reactive attachment disorder of childhoodmaltreatment syndromes (T74.-) names T74.-, which includes this code
- Z62 Problems related to upbringingmaltreatment syndrome (T74.-) names T74.-, which includes this code
- Z62.815 Personal history of intimate partner abuse in childhoodadult 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 circumstancesmaltreatment syndrome (T74.-, T76) names T74.-, which includes this code
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Convert T74.91XS to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About T74.91XSOverview
What is the ICD-10 code for unspecified adult maltreatment, confirmed, sequela?
The ICD-10-CM code for unspecified adult maltreatment, confirmed, sequela is T74.91XS (sometimes written as T7491XS). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is T74.91XS (Unspecified adult maltreatment, confirmed) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report unspecified adult maltreatment, confirmed, sequela on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What does the 7th character S in T74.91XS mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the unspecified adult maltreatment, confirmed itself has resolved, not the original event.
What MS-DRG does T74.91XS group to?
When unspecified adult maltreatment, confirmed, sequela 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.
Who can T74.91XS be reported for?
The Medicare Code Editor checks unspecified adult maltreatment, confirmed, sequela against patient demographics: this code is intended for adult patients (age 15 through 124). Claims outside these limits are flagged as inconsistent.
