T76 vs Z04.41
T76 (Adult and child abuse, neglect and other maltreatment, suspected) compared with Z04.41 (Encounter for examination and observation following alleged adult rape), 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 carries an Excludes1 note covering Z04.41: “suspected adult sexual abuse, ruled out (Z04.41)”
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
| T76Adult and child abuse, neglect and other maltreatment, suspected | Z04.41Encounter for examination and observation following alleged adult rape | |
|---|---|---|
| Billing status | Non-billable header Report instead: T76.01XA, T76.01XD, T76.01XS, T76.02XA, T76.02XD | Billable |
| Classification | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) | Z00-Z99 — Factors Influencing Health Status and Contact with Health Services (Z00-Z99) |
| Definition | Adult and child abuse, neglect and other maltreatment, suspected is a non-billable ICD-10-CM category code (T76). | Encounter for examination and observation following alleged adult rape is a billable ICD-10-CM diagnosis code (Z04.41). |
| 7th character | The appropriate 7th character is to be added to each code from category T76 | — |
| Includes | — | encounter for examination for medicolegal reasons This category is to be used when a person without a diagnosis is suspected of having an abnormal condition, without signs or symptoms, which requires study, but after examination and observation, is ruled-out. This category is also for use for administrative and legal observation status. Suspected adult rape, ruled out Suspected adult sexual abuse, ruled out |
| Use additional code | 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