T76.21XA — Adult sexual abuse, suspected, initial encounter
Is T76.21XA billable?
Yes — T76.21XA is billable for FY2027. T76.21XA is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. T76.21XA may be submitted for encounters from October 1, 2026 through September 30, 2027.
T76.21XA at a glance
| Code | T76.21XA |
|---|---|
| Description | Adult sexual abuse, suspected, initial encounter |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
| 7th character "A" | initial encounter |
What does the 7th character "A" mean in T76.21XA?
In T76.21XA, the 7th character A means initial encounter. The 7th character is required for T76.21XA to be a valid, complete code.
Same condition, different episode of care — switch the 7th character:
Which MS-DRGs does T76.21XA group to?
T76.21XA sits in MDC 21 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 922Other Injury, Poisoning and Toxic Effect Diagnoses with MCCmedical
- 923Other Injury, Poisoning and Toxic Effect Diagnoses without MCCmedical
As a secondary diagnosis, T76.21XA is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is T76.21XA listed in the Alphabetic Index?
The Alphabetic Index lists these routes under T76.21, the nearest indexed parent of T76.21XA. Use them to find the family, then select the specific code.
- Rape › adult › suspected
- Maltreatment › adult › sexual abuse › suspected
How is T76.21XA listed in the External Cause Index?
The External Cause of Injuries Index lists these routes under T76.2, the nearest indexed parent of T76.21XA. This is a separate index from the Alphabetic Index and is where external cause codes are looked up.
- Rape › suspected (attempted) (confirmed)
- Assault › rape › suspected (homicidal) (by) (in)
- Assault › sexual › suspected (homicidal) (by) (in)
- Assault › bodily force › sexual › suspected (homicidal) (by) (in)
Excludes1 — never code together — inherited from T76
The conditions below can never be reported together with T76.21XA on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- 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)
Excludes1 — never code together — inherited from T76.2
The conditions below can never be reported together with T76.21XA on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- alleged abuse, ruled out (Z04.7)
Use additional code — inherited from Chapter 19
Report an additional code alongside T76.21XA to fully describe the condition. T76.21XA is sequenced first.
- code to identify any retained foreign body, if applicable (Z18.-)
Use additional code — inherited from T76
Report an additional code alongside T76.21XA to fully describe the condition. T76.21XA is sequenced first.
- code, if applicable, to identify any associated current injury
Excludes2 — not included here — inherited from Chapter 19
The conditions below are not part of T76.21XA, but a patient may have both at the same time. When documentation supports it, T76.21XA and the excluded code may both be reported.
Code also — inherited from T66-T78
Two codes may be needed to describe the condition fully. Whether T76.21XA is sequenced first depends on the reason for the encounter.
- , 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-)
How long has T76.21XA existed?
T76.21XA has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.