2026 ICD-10-CM Diagnosis Code T76.21XSAdult sexual abuse, suspected, sequela

ICD-10-CM Codes›S00–T88›T66-T78›T76

ICD-10-CM T76.21XS
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

T76.21XS is a billable ICD-10-CM diagnosis code for adult sexual 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

ICD-10-CM Code
T76.21XS
Billable Status
Yes — Valid for Submission
Code Describes
Adult sexual abuse, suspected, sequela
Short Description
Adult sexual abuse, suspected, sequela
Same as the full description in the CMS dataset.
Parent Code
T76.21
Adult sexual 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 CodeT76.21XSAdult sexual abuse, suspected, sequela

Code EditsBilling

Medicare Code Editor checks that affect claim validity for T76.21XS.

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

T76.21XS 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.

  • Alleged victim of sexual assault
  • Homicide and assault by fight, brawl and rape
  • Homicide or assault by rape
  • Suspected elderly person maltreatment
  • Suspected victim of abuse by intimate partner
  • Suspected victim of adult abuse
  • Suspected victim of adult sexual abuse
  • Suspected victim of elder sexual abuse
  • Suspected victim of sexual abuse
  • Suspected victim of sexual abuse by intimate partner
  • Suspected victim of sexual grooming

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.

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

Patient EducationClinical

Sexual Assault

Sexual assault is any kind of sexual activity, contact, or experience that happens without your consent. That means the sexual activity happens even though you don't agree to it.

The full article covers:

  • What is sexual assault?
  • What does sexual assault include?
  • What does "consent" mean?
  • Who commits sexual assault?
  • What are the possible health effects from sexual assault?
  • What can I do if I'm a victim of sexual assault?
  • Can sexual assault be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert T76.21XS 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 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About T76.21XSOverview

Is T76.21XS (Adult sexual abuse, suspected) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report adult sexual abuse, suspected, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What does the 7th character S in T76.21XS mean?

The final character S makes this a sequela code: it reports a lingering problem that remains after the adult sexual abuse, suspected itself has resolved, not the original event.

What MS-DRG does T76.21XS group to?

When adult sexual 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 T76.21XS be reported for?

The Medicare Code Editor checks adult sexual 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 T76.21XS 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 sexual 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.