ICD-10 Code T76.21XS

Adult sexual abuse, suspected, sequela

Version 2019 Replaced Code Billable Code Adult Diagnoses POA Exempt
ICD-10: T76.21XS
Short Description:Adult sexual abuse, suspected, sequela
Long Description:Adult sexual abuse, suspected, sequela

Valid for Submission

ICD-10 T76.21XS is a billable code used to specify a medical diagnosis of adult sexual abuse, suspected, sequela. The code is valid for the year 2019 for the submission of HIPAA-covered transactions.

Deleted Code

This code was deleted in the 2019 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, 2018. This code was replaced for the FY 2019 (October 1, 2018 - September 30, 2019).

  • T76.51XS - Adult forced sexual exploitation, suspected, sequela

Code Classification

  • 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)

Information for Medical Professionals

Code Edits

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:

  • Adult diagnoses - Adult. Age range is 15–124 years inclusive (e.g., senile delirium, mature cataract).

Convert T76.21XS to ICD-9

The following crosswalk between ICD-10 to ICD-9 is based based on the General Equivalence Mappings (GEMS) information:

  • 909.9 - Late eff exter cause NEC (Approximate Flag)

Present on Admission (POA)

T76.21XS 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.

CMS POA Indicator Options and Definitions
POA Indicator CodePOA Reason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Synonyms

The following clinical terms are approximate synonyms:

  • Homicide and assault by fight, brawl and rape
  • Homicide or assault by rape
  • Suspected victim of sexual abuse
  • Suspected victim of sexual grooming

Information for Patients


Sexual Assault

Also called: Rape

Sexual assault is any sexual activity to which you haven't freely given your consent. This includes completed or attempted sex acts that are against your will. Sometimes it can involve a victim who is unable to consent. It also includes abusive sexual contact. It can happen to men, women or children.

The attacker can be anyone - a current or former partner, a family member, a person in position of power or trust, a friend, an acquaintance, or a stranger.

Sexual assault can affect your health in many ways. It can lead to long-term health and emotional problems. It is important to seek help if you have been assaulted. First, get to a safe place. Then dial 9-1-1 or go to a hospital for medical care. You may want to have counseling to deal with your feelings. The most important thing to know is that the assault was not your fault.

Centers for Disease Control and Prevention

  • Rape (Medical Encyclopedia)

[Learn More]

ICD-10 Footnotes

General Equivalence Map Definitions
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

  • Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
  • No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
  • Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.