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O9A.4 vs T74.91XS

O9A.4 (Sexual abuse complicating pregnancy, childbirth and the puerperium) compared with T74.91XS (Unspecified adult maltreatment, confirmed, sequela), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Can these codes be reported together?

No — do not report together. T74.91XS carries an Excludes1 note covering O9A.4: “abuse and maltreatment in pregnancy (O9A.3-, O9A.4-, O9A.5-)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Side by side

O9A.4Sexual abuse complicating pregnancy, childbirth and the puerperiumT74.91XSUnspecified adult maltreatment, confirmed, sequela
Billing statusNon-billable header

Report instead: O9A.411, O9A.412, O9A.413, O9A.419, O9A.42

Billable
ClassificationO00-O9A — Pregnancy, Childbirth and the Puerperium (O00-O9A)S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)
DefinitionSexual abuse complicating pregnancy, childbirth and the puerperium is a non-billable ICD-10-CM category code (O9A.4).Unspecified adult maltreatment, confirmed, sequela is a billable ICD-10-CM diagnosis code (T74.91S).
7th characterThe appropriate 7th character is to be added to each code from category T74
Includes
Conditions in T74.21 or T76.21
Use additional code
code (if applicable):
to identify any associated current injury due to sexual abuse
to identify the perpetrator of abuse (Y07.-)
code, if applicable, to identify any associated current injury
external cause code to identify perpetrator, if known (Y07.-)

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources