2026 ICD-10-CM Diagnosis Code T76.11XSAdult physical abuse, suspected, sequela
T76.11XS is a billable ICD-10-CM diagnosis code for adult physical abuse, 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. 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 T76.11XS.
Present on Admission (POA)Billing
T76.11XS 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 abuse by intimate partner
- Suspected victim of adult abuse
- Suspected victim of adult physical abuse
- Suspected victim of elder physical abuse
- Suspected victim of physical abuse
- Suspected victim of physical abuse by intimate partner
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 T76.11XS to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About T76.11XSOverview
Is T76.11XS (Adult physical abuse, suspected) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report adult physical abuse, suspected, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in T76.11XS mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the adult physical abuse, suspected itself has resolved, not the original event.
What MS-DRG does T76.11XS group to?
When adult physical abuse, 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 T76.11XS be reported for?
The Medicare Code Editor checks adult physical abuse, 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 T76.11XS 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 physical abuse, 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.
