Valid for Submission
T76.12XD is a billable code used to specify a medical diagnosis of child physical abuse, suspected, subsequent encounter. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code T76.12XD might also be used to specify conditions or terms like suspected non-accidental injury to child or suspected victim of child abuse or suspected victim of child physical abuse or suspected victim of physical abuse. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
The code T76.12XD is applicable for patients aged 0 through 17 years inclusive. It is clinically and virtually impossible to use this code on a patient outside the stated age range.
|Short Description:||Child physical abuse, suspected, subsequent encounter|
|Long Description:||Child physical abuse, suspected, subsequent encounter|
This code was replaced in the 2020 ICD-10 code set with the code(s) listed below. The National Center for Health Statistics (NCHS) has published an update to the ICD-10-CM diagnosis codes which became effective October 1, 2019. This code was replaced for the FY 2020 (October 1, 2019 - September 30, 2020).
- T76.62XD - Child forced labor exploitation, suspected, subs
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:
- Pediatric diagnoses - Pediatric. Age range is 0–17 years inclusive (e.g., Reye’s syndrome, routine child health exam).
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Suspected non-accidental injury to child
- Suspected victim of child abuse
- Suspected victim of child physical abuse
- Suspected victim of physical abuse
Diagnostic Related Groups
The ICD-10 code T76.12XD is grouped in the following groups for version MS-DRG V37.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). applicable from 10/01/2019 through 09/30/2020.
- 949 - AFTERCARE WITH CC/MCC
- 950 - AFTERCARE WITHOUT CC/MCC
Present on Admission (POA)
T76.12XD is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here .
CMS POA Indicator Options and Definitions
|POA Indicator Code||POA Reason for Code||CMS will pay the CC/MCC DRG?|
|Y||Diagnosis was present at time of inpatient admission.||YES|
|N||Diagnosis was not present at time of inpatient admission.||NO|
|U||Documentation insufficient to determine if the condition was present at the time of inpatient admission.||NO|
|W||Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.||YES|
|1||Unreported/Not used - Exempt from POA reporting. ||NO|
Convert T76.12XD to ICD-9
- V58.89 - Other specfied aftercare (Approximate Flag)
Injury, poisoning and certain other consequences of external causes (S00–T98)
Other and unspecified effects of external causes (T66-T78)
Adult and child abuse, neglect and oth maltreat, suspected (T76)
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
(First year ICD-10-CM implemented into the HIPAA code set)
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020