2026 ICD-10-CM Diagnosis Code T74.91XSUnspecified adult maltreatment, confirmed, sequela

ICD-10-CM CodesS00–T88T66-T78T74

ICD-10-CM T74.91XS
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

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 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) and exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Effect of other external causes, sequela.

Code Identity

ICD-10-CM Code
T74.91XS
Billable Status
Yes — Valid for Submission
Code Describes
Unspecified adult maltreatment, confirmed, sequela
Short Description
Unspecified adult maltreatment, confirmed, sequela
Same as the full description in the CMS dataset.
Parent Code
Unspecified adult maltreatment, 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 CodeT74.91XSUnspecified adult maltreatment, confirmed, sequela

Code EditsBilling

Medicare Code Editor checks that affect claim validity for T74.91XS.

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).

Present on Admission (POA)Billing

T74.91XS is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.

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.

CCSR INJ074
Effect of other external causes, sequela
Default principal diagnosis: inpatient Yes · outpatient Yes

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 T74.91XS to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
909.9 Late eff exter cause NEC
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 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About T74.91XSOverview

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, 2025 through September 30, 2026.

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 922, 923, with relative weights from 1.0177 to 1.7494 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.

Is T74.91XS exempt from POA reporting?

Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for unspecified adult maltreatment, confirmed, sequela on inpatient claims.

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.