2026 ICD-10-CM Diagnosis Code T76.51XSAdult forced sexual exploitation, suspected, sequela
T76.51XS is a billable ICD-10-CM diagnosis code for adult forced sexual exploitation, 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 T76.51XS.
Present on Admission (POA)Billing
T76.51XS is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.
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.
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.
Code History & ChangesHistory
Replacement T76.51XS replaces the following previously assigned code(s):
- T76.21XS - Adult sexual abuse, suspected, sequela
Questions About T76.51XSOverview
Is T76.51XS (Adult forced sexual exploitation, suspected) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report adult forced sexual exploitation, suspected, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in T76.51XS mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the adult forced sexual exploitation, suspected itself has resolved, not the original event.
What MS-DRG does T76.51XS group to?
When adult forced sexual exploitation, 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 T76.51XS be reported for?
The Medicare Code Editor checks adult forced sexual exploitation, 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 T76.51XS 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 forced sexual exploitation, 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.
