T74.91XA (Unspecified adult maltreatment, confirmed, initial encounter) compared with T74.91XD (Unspecified adult maltreatment, confirmed, subsequent encounter), from the official CMS tabular data. T74.91XA and T74.91XD code the same injury at a different phase of treatment.
Same underlying diagnosis, different encounter phase.
The 7th character records the phase of care for the encounter being coded, so a single encounter takes one of these characters, not several. Review whether both phases belong on the same episode of care.
Source: ICD-10-CM Official Guidelines, Section I.C.19.a
Same injury, other encounter phase. T74.91XA and T74.91XD code the same injury at a different phase of treatment, set by the 7th character.
The 7th character records the type of care given at the encounter being coded (ICD-10-CM Official Guidelines, Section I.C.19.a), so one encounter takes one of these, not both.
| T74.91XAUnspecified adult maltreatment, confirmed, initial encounter | T74.91XDUnspecified adult maltreatment, confirmed, subsequent encounter | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Unspecified adult maltreatment, confirmed, initial encounter is a billable ICD-10-CM diagnosis code (T74.91A). | Unspecified adult maltreatment, confirmed, subsequent encounter is a billable ICD-10-CM diagnosis code (T74.91D). |
| 7th character | The appropriate 7th character is to be added to each code from category T74 | The appropriate 7th character is to be added to each code from category T74 |
| Use additional code | code, if applicable, to identify any associated current injury external cause code to identify perpetrator, if known (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