2026 ICD-10-CM Diagnosis Code T76.01XSAdult neglect or abandonment, suspected, sequela
T76.01XS is a billable ICD-10-CM diagnosis code for adult neglect or abandonment, suspected, 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. Coders also document this condition as suspected elderly person maltreatment. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Effect of other external causes, sequela.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for T76.01XS.
Present on Admission (POA)Billing
T76.01XS 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.
- Suspected elderly person maltreatment
- Suspected victim of elder neglect
Coding GuidelinesGuidance
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 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.
Convert T76.01XS to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About T76.01XSOverview
Is T76.01XS (Adult neglect or abandonment, suspected) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report adult neglect or abandonment, suspected, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in T76.01XS mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the adult neglect or abandonment, suspected itself has resolved, not the original event.
What MS-DRG does T76.01XS group to?
When adult neglect or abandonment, suspected, 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 T76.01XS be reported for?
The Medicare Code Editor checks adult neglect or abandonment, suspected, sequela against patient demographics: this code is intended for adult patients (age 15 through 124). Claims outside these limits are flagged as inconsistent.
Is T76.01XS 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 adult neglect or abandonment, suspected, 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.
