Version 2024

2024 ICD-10-CM Diagnosis Code T76.A2XS

Child financial abuse, suspected, sequela

ICD-10-CM Code:: T76.A2XS
ICD-10 Code for:: Child financial abuse, suspected, sequela
Is Billable?: Yes - Valid for Submission
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Code Information
Coding Guidelines
Tabular List of Diseases and Injuries
Code Edits
Diagnostic Related Groups Mapping
Present on Admission (POA)
Replacement Code
Patient Education
Other Codes Used Similar Conditions
Code History

Code Classification

Injury, poisoning and certain other consequences of external causes
(S00–T88)
- Other and unspecified effects of external causes
  (T66-T78)
  - Adult and child abuse, neglect and other maltreatment, suspected
    (T76)

T76.A2XS is a billable diagnosis code used to specify a medical diagnosis of child financial abuse, suspected, sequela. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code T76.A2XS 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.

T76.A2XS is a sequela code, includes a 7th character and should be used for complications that arise as a direct result of a condition like child financial abuse suspected. According to ICD-10-CM Guidelines a "sequela" code should be used for chronic or residual conditions that are complications of an initial acute disease, illness or injury. The most common sequela is pain. Usually, two diagnosis codes are needed when reporting sequela. The first code describes the nature of the sequela while the second code describes the sequela or late effect.

Coding Guidelines

The appropriate 7th character is to be added to each code from block Adult and child abuse, neglect and other maltreatment, suspected (T76). Use the following options for the aplicable episode of care:

A - initial encounter
D - subsequent encounter
S - sequela

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:

Pediatric diagnoses - The Medicare Code Editor detects inconsistencies in pediatric cases by checking a patient's age and any diagnosis on the patient's record. The pediatric code edits apply to patients age range is 0–17 years inclusive (e.g., Reye's syndrome, routine child health exam).

T76.A2XS is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
922	OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC	21	1.7449
923	OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC	21	1.0114

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Present on Admission (POA)

T76.A2XS 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	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

Replacement Code

T76A2XS replaces the following previously assigned ICD-10-CM code(s):

T76.92XS - Unspecified child maltreatment, suspected, sequela

Other ICD-10-CM Codes Commonly Used for Similar Conditions

Filter related codes list:

T76 Adult and child abuse, neglect and other maltreatment, suspected.
T76.0 Neglect or abandonment, suspected.
T76.01 Adult neglect or abandonment, suspected.
T76.01XA Adult neglect or abandonment, suspected, initial encounter.
T76.01XD Adult neglect or abandonment, suspected, subsequent encounter.
T76.01XS Adult neglect or abandonment, suspected, sequela.
T76.02 Child neglect or abandonment, suspected.
T76.02XA Child neglect or abandonment, suspected, initial encounter.
T76.02XD Child neglect or abandonment, suspected, subsequent encounter.
T76.02XS Child neglect or abandonment, suspected, sequela.
T76.1 Physical abuse, suspected.
T76.11 Adult physical abuse, suspected.
T76.11XA Adult physical abuse, suspected, initial encounter.
T76.11XD Adult physical abuse, suspected, subsequent encounter.
T76.11XS Adult physical abuse, suspected, sequela.
T76.12 Child physical abuse, suspected.
T76.12XA Child physical abuse, suspected, initial encounter.
T76.12XD Child physical abuse, suspected, subsequent encounter.
T76.12XS Child physical abuse, suspected, sequela.
T76.2 Sexual abuse, suspected.
T76.21 Adult sexual abuse, suspected.
T76.21XA Adult sexual abuse, suspected, initial encounter.
T76.21XD Adult sexual abuse, suspected, subsequent encounter.
T76.21XS Adult sexual abuse, suspected, sequela.
T76.22 Child sexual abuse, suspected.
T76.22XA Child sexual abuse, suspected, initial encounter.
T76.22XD Child sexual abuse, suspected, subsequent encounter.
T76.22XS Child sexual abuse, suspected, sequela.
T76.3 Psychological abuse, suspected.
T76.31 Adult psychological abuse, suspected.
T76.31XA Adult psychological abuse, suspected, initial encounter.
T76.31XD Adult psychological abuse, suspected, subsequent encounter.
T76.31XS Adult psychological abuse, suspected, sequela.
T76.32 Child psychological abuse, suspected.
T76.32XA Child psychological abuse, suspected, initial encounter.
T76.32XD Child psychological abuse, suspected, subsequent encounter.
T76.32XS Child psychological abuse, suspected, sequela.
T76.5 Forced sexual exploitation, suspected.
T76.51 Adult forced sexual exploitation, suspected.
T76.51XA Adult forced sexual exploitation, suspected, initial encounter.
T76.51XD Adult forced sexual exploitation, suspected, subsequent encounter.
T76.51XS Adult forced sexual exploitation, suspected, sequela.
T76.52 Child sexual exploitation, suspected.
T76.52XA Child sexual exploitation, suspected, initial encounter.
T76.52XD Child sexual exploitation, suspected, subsequent encounter.
T76.52XS Child sexual exploitation, suspected, sequela.
T76.6 Forced labor exploitation, suspected.
T76.61 Adult forced labor exploitation, suspected.
T76.61XA Adult forced labor exploitation, suspected, initial encounter.
T76.61XD Adult forced labor exploitation, suspected, subsequent encounter.
T76.61XS Adult forced labor exploitation, suspected, sequela.

Code History

FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024