2027 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 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. 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 the other POA exempt codes in Other and unspecified effects of external causes (T66-T78).
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 T76.51XS: 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.
- 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.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code, if applicable, to identify any associated current injury
- 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.
- 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.
- 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.
- The appropriate 7th character is to be added to each code from category T76
- 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 T76.51XS, its category, or a range that includes it.
Applicable To 1
These notes mention T76.51XS.
Excludes1 3
These codes carry an Excludes1 note naming T76.51XS: they are not reported together with it, unless the two conditions are unrelated.
- T74 Adult and child abuse, neglect and other maltreatment, confirmedadult and child maltreatment, suspected (T76.-) names T76.-, which includes this code
- Z04.71 Encounter for examination and observation following alleged adult physical abusesuspected 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 abusesuspected case of child physical abuse, not ruled out (T76.-) names T76.-, which includes this code
Excludes2 1
These codes carry an Excludes2 note naming T76.51XS: its condition is not part of those codes, and both may be reported when the patient has both.
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
What is the ICD-10 code for adult forced sexual exploitation, suspected, sequela?
The ICD-10-CM code for adult forced sexual exploitation, suspected, sequela is T76.51XS (sometimes written as T7651XS). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
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, 2026 through September 30, 2027.
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 923, 922, with relative weights from 0.9980 to 1.6248 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.