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O9A.4 vs T76.92XA

O9A.4 (Sexual abuse complicating pregnancy, childbirth and the puerperium) compared with T76.92XA (Unspecified child maltreatment, suspected, initial encounter), 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. T76.92XA carries an Excludes1 note covering O9A.4: “suspected 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 puerperiumT76.92XAUnspecified child maltreatment, suspected, initial encounter
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 child maltreatment, suspected, initial encounter is a billable ICD-10-CM diagnosis code (T76.92A).
7th characterThe appropriate 7th character is to be added to each code from category T76
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

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