2027 ICD-10-CM Diagnosis Code T76.11XSAdult physical abuse, suspected, sequela

ICD-10-CM Codes›S00–T88›T66-T78›T76

ICD-10-CM T76.11XS
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

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 2027 (October 1, 2026 through September 30, 2027) 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

ICD-10-CM Code
T76.11XS
Billable Status
Yes — Valid for Submission
Code Describes
Adult physical abuse, suspected, sequela
Short Description
Adult physical abuse, suspected, sequela
Same as the full description in the CMS dataset.
Parent Code
T76.11
Adult physical abuse, suspected

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionT66-T78Other and unspecified effects of external causes
CategoryT76Adult and child abuse, neglect and other maltreatment, suspected
This CodeT76.11XSAdult physical abuse, suspected, sequela

Code EditsBilling

Medicare Code Editor checks that affect claim validity for T76.11XS.

Adult diagnoses
The Medicare Code Editor detects inconsistencies in adult cases by checking a patient's age and any diagnosis on the patient's record. The adult code edits apply to patients age range is 15–124 years inclusive (e.g., senile delirium, mature cataract).

Present on Admission (POA)Billing

T76.11XS is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Other and unspecified effects of external causes (T66-T78).

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 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 2027, published by CMS and the National Center for Health Statistics.

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to T76.11XS: its own notes plus those printed at T76, block T66-T78, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From T76 Adult and child abuse, neglect and other maltreatment, suspected applies to 48 codes
  • adult and child maltreatment, confirmed (T74.-)
  • suspected abuse and maltreatment in pregnancy (O9A.3-, O9A.4-, O9A.5-)
  • suspected adult physical abuse, ruled out (Z04.71)
  • suspected adult sexual abuse, ruled out (Z04.41)
  • suspected child physical abuse, ruled out (Z04.72)
  • suspected child sexual abuse, ruled out (Z04.42)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From T76 Adult and child abuse, neglect and other maltreatment, suspected applies to 48 codes
  • code, if applicable, to identify any associated current injury
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • code to identify any retained foreign body, if applicable (Z18.-)

Code Also

A second code may be needed to fully describe the condition; the note gives no sequencing direction.

From Block T66-T78 Other and unspecified effects of external causes applies to 456 codes
  • if applicable, place of occurrence, such as:
  • highway rest stop (Y92.523)
  • school (private) (public) (state) as the place of occurrence of the external cause (Y92.21-)
  • service areas as the place of occurrence of the external cause (Y92.52-)
  • single-family non-institutional (private) house as the place of occurrence of the external cause (Y92.01-)
  • transport vehicle as the place of occurrence of the external cause (Y92.81-)

Notes

General instructions on how these codes are used.

From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
  • The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.

7th Character

Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.

From T76 Adult and child abuse, neglect and other maltreatment, suspected applies to 48 codes
  • The appropriate 7th character is to be added to each code from category T76
Values for category T76 Encounter: Initial, Subsequent, Sequela
  • Ainitial encounter
  • Dsubsequent encounter
  • Ssequela this code

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name T76.11XS, its category, or a range that includes it.

Applicable To 2

These notes mention T76.11XS.

  • O9A.2 Injury, poisoning and certain other consequences of external causes complicating pregnancy, childbirth and the puerperium
    Conditions in S00-T88, except T74 and T76 names T76, which includes this code
  • O9A.3 Physical abuse complicating pregnancy, childbirth and the puerperium
    Conditions in T74.11 or T76.11 names T76.11, which includes this code

Excludes1 5

These codes carry an Excludes1 note naming T76.11XS: they are not reported together with it, unless the two conditions are unrelated.

  • T74 Adult and child abuse, neglect and other maltreatment, confirmed
    adult and child maltreatment, suspected (T76.-) names T76.-, which includes this code
  • Z04.71 Encounter for examination and observation following alleged adult physical abuse
    suspected case of adult physical abuse, not ruled out (T76.-) names T76.-, which includes this code
  • Z04.72 Encounter for examination and observation following alleged child physical abuse
    suspected case of child physical abuse, not ruled out (T76.-) names T76.-, which includes this code
  • Z91.410 Personal history of adult physical and sexual abuse
    current adult physical abuse (T74.11, T76.11) names T76.11, which includes this code
  • Z91.410 Personal history of adult physical and sexual abuse
    current adult sexual abuse (T74.21, T76.11) names T76.11, which includes this code

Excludes2 1

These codes carry an Excludes2 note naming T76.11XS: its condition is not part of those codes, and both may be reported when the patient has both.

  • Z63 Other problems related to primary support group, including family circumstances
    maltreatment syndrome (T74.-, T76) names T76, which includes this code

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR INJ074
Effect of other external causes, sequela
Default principal diagnosis: inpatient Yes · outpatient Yes

Convert T76.11XS to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
909.9 Late eff exter cause NEC
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About T76.11XSOverview

What is the ICD-10 code for adult physical abuse, suspected, sequela?

The ICD-10-CM code for adult physical abuse, suspected, sequela is T76.11XS (sometimes written as T7611XS). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

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, 2026 through September 30, 2027.

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 923, 922, with relative weights from 0.9980 to 1.6248 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.