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T74.12XD vs T74.4

T74.12XD (Child physical abuse, confirmed, subsequent encounter) compared with T74.4 (Shaken infant syndrome), from the official CMS tabular data.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Summary

These codes can be reported together when both conditions are documented, because T74.12XD lists T74.4 under Excludes2, which marks them as distinct conditions.

Official rule
What is different?

The conditions named and billing status.T74.12XD is “Child physical abuse, confirmed, subsequent encounter”; T74.4 is “Shaken infant syndrome”. T74.4 is a non-billable header; T74.12XD is billable.

Registry fact

Can these codes be reported together?

Yes, when both are documented.T74.12XD lists T74.4 under Excludes2: “shaken infant syndrome (T74.4)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes2 relationship?

Yes.T74.12XD’s tabular entry: “shaken infant syndrome (T74.4)”. The note covers T74.4.

Official ruleGuide: Excludes1 vs Excludes2

Is one a parent or header code?

One is a header.T74.4 is a non-billable header, but T74.12XD is not one of its subdivisions.

Registry fact

Nothing found in 4 other checks
Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. T74.12XD carries 2 Excludes1 notes and T74.4 carries 2 Excludes1 notes covering other codes; the side-by-side table quotes them.

Official rule

Is one more specific?

No.Neither is a subdivision of the other, and neither title is the unspecified form; they describe different conditions within category T74.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Informational

Excludes2 relationship

T74.12XD
Child physical abuse, confirmed, subsequent encounter
↔
T74.4
Shaken infant syndrome

What we found

Yes, when both are documented.T74.12XD carries an Excludes2 note covering T74.4: “shaken infant syndrome (T74.4)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

  • Section I.A.12.b — Excludes2 · applies to: Excludes2

    A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.

    ICD-10-CM Official Guidelines FY2027

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

Similar descriptions do not make codes interchangeable. The documentation and the official instructions decide which code applies.

Official descriptionDiffers
T74.12XD

Child physical abuse, confirmed, subsequent encounter

T74.4

Shaken infant syndrome

StatusDiffers
T74.12XD
Billable
T74.4
Non-billable header

A header is not reported on a claim; a code beneath it is.

Report instead: T74.4XXA, T74.4XXD, T74.4XXS

Excludes1Same for both
  • abuse and maltreatment in pregnancy (O9A.3-, O9A.4-, O9A.5-)
  • adult and child maltreatment, suspected (T76.-)
Excludes2Differs
T74.12XD
  • shaken infant syndrome (T74.4)
  • sexual abuse (T74.2-)
T74.4

None at this code

Use additional codeSame for both
  • code, if applicable, to identify any associated current injury
  • external cause code to identify perpetrator, if known (Y07.-)
Code alsoSame for both
  • , 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-)
CategorySame for both

T74 Adult and child abuse, neglect and other maltreatment, confirmed

ChapterSame for both

S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)

7th characterSame for both
  • The appropriate 7th character is to be added to each code from category T74

No Code first and Includes note at either code.

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on. In a row that differs, each code’s own notes are listed under it, and the notes every code shares are listed once beneath them.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources