ICD-10 Code T76.22XD

Child sexual abuse, suspected, subsequent encounter

Version 2019 Replaced Code Billable Code Pediatric Diagnoses POA Exempt
ICD-10:T76.22XD
Short Description:Child sexual abuse, suspected, subsequent encounter
Long Description:Child sexual abuse, suspected, subsequent encounter

Valid for Submission

ICD-10 T76.22XD is a billable code used to specify a medical diagnosis of child sexual abuse, suspected, subsequent encounter. 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).

  • T76.52XD - Child sexual exploitation, suspected, subsequent encounter

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:

  • Pediatric diagnoses - Pediatric. Age range is 0–17 years inclusive (e.g., Reye’s syndrome, routine child health exam).

Convert T76.22XD to ICD-9

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

  • V58.89 - Other specfied aftercare (Approximate Flag)

Present on Admission (POA)

T76.22XD 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 child abuse
  • Suspected victim of child sexual abuse
  • Suspected victim of sexual abuse
  • Suspected victim of sexual grooming

Information for Patients


Child Sexual Abuse

Sexual abuse is one form of child abuse. It includes a wide range of actions between a child and an adult or older child. Often these involve body contact, but not always. Exposing one's genitals to children or pressuring them for sex is sexual abuse. Using a child for pornography is also sexual abuse.

Most sexual abusers know the child they abuse. They may be family friends, neighbors or babysitters. About one-third of abusers are related to the child. Most abusers are men. If you think a child may have been abused, it's important to report it.

  • Sexual abuse in children -- what to know (Medical Encyclopedia)

[Read 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.