2026 ICD-10-CM Diagnosis Code T76.A1XAAdult financial abuse, suspected, initial encounter

ICD-10-CM Codes›S00–T88›T66-T78›T76

ICD-10-CM T76.A1XA
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

T76.A1XA is a billable ICD-10-CM diagnosis code for adult financial abuse, suspected, initial encounter. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. 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). In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Effect of other external causes, initial encounter; External cause codes: intent of injury, assault; and External cause codes: other specified, classifiable and NEC; initial encounter.

Code Identity

ICD-10-CM Code
T76.A1XA
Billable Status
Yes — Valid for Submission
Code Describes
Adult financial abuse, suspected, initial encounter
Short Description
Adult financial abuse, suspected, initial encounter
Same as the full description in the CMS dataset.
Parent Code
T76.A1
Adult financial 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.A1XAAdult financial abuse, suspected, initial encounter

Code EditsBilling

Medicare Code Editor checks that affect claim validity for T76.A1XA.

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).

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 INJ021
Effect of other external causes, initial encounter
Default principal diagnosis: inpatient Yes · outpatient Yes
CCSR EXT022
External cause codes: intent of injury, assault
Default principal diagnosis: inpatient No · outpatient No
CCSR EXT018
External cause codes: other specified, classifiable and NEC; initial encounter
Default principal diagnosis: inpatient No · outpatient No

Code History & ChangesHistory

Replacement T76.A1XA replaces the following previously assigned code(s):

  • T76.91XA - Unspecified adult maltreatment, suspected, initial encounter
FY 2024AddedAdded to the ICD-10-CM code setEffective October 1, 2023.
FY 2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About T76.A1XAOverview

Is T76.A1XA (Adult financial abuse, suspected) a billable code?

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

What does the 7th character A in T76.A1XA mean?

The final character A marks the initial encounter: use it while the patient is receiving active treatment for adult financial abuse, suspected, such as an emergency visit or first evaluation.

What MS-DRG does T76.A1XA group to?

When adult financial abuse, suspected, initial encounter 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.A1XA be reported for?

The Medicare Code Editor checks adult financial abuse, suspected, initial encounter against patient demographics: this code is intended for adult patients (age 15 through 124). Claims outside these limits are flagged as inconsistent.

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.