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T76.A1XA ICD-10-CM Code: Adult financial abuse, suspected, initial encounter

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 922 — OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC (MDC 21)
  • MS-DRG 923 — OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC (MDC 21)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Official Registry Overview & Definition

Adult financial abuse, suspected, initial encounter is a billable ICD-10-CM diagnosis code (T76.A1A).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for T76.A1XA in the official ICD-10-CM tabular list.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Code Also

Additional codes that may be required to fully describe the encounter.

  • Code also, 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-)

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code, if applicable, to identify any associated current injury

Frequently Compared Codes

The official Excludes notes on T76.A1XA name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

  • FY2024 — 2023-10-01
    Added to the code set
    Adult financial abuse, suspected, initial encounter
    FY2024 changes

Verify Before Coding

  • Age-restricted: the Medicare Code Editor lists this as a adult (age 15-124) diagnosis; other ages are presumed incorrect.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.

Relationships & Classification

Official ICD-10-CM tabular notes on other codes that name T76.A1XA or its code family.

3 Excludes1 notes across 2 chapters: T74 (via T76.-), Z04.71 (via T76.-), Z04.72 (via T76.-).

Potential MS-DRG Relationships (FY2026)

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 2 MS-DRGs: DRG 922 (MDC 21), DRG 923 (MDC 21).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):INJ021 — Effect of other external causes, initial encounter (default); EXT018 — External cause codes: other specified, classifiable and NEC; initial encounter; EXT022 — External cause codes: intent of injury, assault.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Contextual Map

Every relationship of T76.A1XA in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

  • S00-T88 — Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) (S00-T88) [Hierarchy]
  • T66-T78 — Other and unspecified effects of external causes [Hierarchy]

Referenced by Excludes1 notes

  • T74 — Adult and child abuse, neglect and other maltreatment, confirmed [Excludes1](via T76.-): “adult and child maltreatment, suspected (T76.-)” · check together
  • Z04.71 — Encounter for examination and observation following alleged adult physical abuse [Excludes1](via T76.-): “suspected case of adult physical abuse, not ruled out (T76.-)” · check together
  • Z04.72 — Encounter for examination and observation following alleged child physical abuse [Excludes1](via T76.-): “suspected case of child physical abuse, not ruled out (T76.-)” · check together

Clinical classification (CCSR)

  • INJ021 — Effect of other external causes, initial encounter [CCSR]
  • EXT018 — External cause codes: other specified, classifiable and NEC; initial encounter [CCSR]
  • EXT022 — External cause codes: intent of injury, assault [CCSR]

Potential MS-DRG

  • DRG 922 — OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC [MS-DRG]: “OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC (MDC 21)”
  • DRG 923 — OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC [MS-DRG]: “OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC (MDC 21)”

MDC crossing · procedures (32029)

  • MDC 21 — Injuries, Poisonings and Toxic Effects of Drugs [MDC crossing]: “Injuries, Poisonings and Toxic Effects of Drugs — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • 0016070 — Bypass Cerebral Ventricle to Nasopharynx with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Nasopharynx with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
  • 0016071 — Bypass Cerebral Ventricle to Mastoid Sinus with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Mastoid Sinus with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
  • 0016072 — Bypass Cerebral Ventricle to Atrium with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Atrium with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
  • 0016073 — Bypass Cerebral Ventricle to Blood Vessel with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Blood Vessel with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
  • 0016074 — Bypass Cerebral Ventricle to Pleural Cavity with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Pleural Cavity with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
  • and 32024 more

Nearest codes (40)

  • T76 — Adult and child abuse, neglect and other maltreatment, suspected [Sibling]
  • T76.31XS — Adult psychological abuse, suspected, sequela [Sibling]
  • T76.32 — Child psychological abuse, suspected [Sibling]
  • T76.32XA — Child psychological abuse, suspected, initial encounter [Sibling]
  • T76.32XD — Child psychological abuse, suspected, subsequent encounter [Sibling]
  • T76.32XS — Child psychological abuse, suspected, sequela [Sibling]
  • T76.5 — Forced sexual exploitation, suspected [Sibling]
  • T76.51 — Adult forced sexual exploitation, suspected [Sibling]
  • and 32 more

Change history

  • FY2024 — Added to the code set [Change history]

Frequently Asked Questions (FAQ) & Clinical Guidance

Does T76.A1XA require a 7th character?

Yes. The appropriate 7th character is to be added to each code from category T76.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to T76.A1XA in its code family, with their registry titles.

  • T76.92XA — Unspecified child maltreatment, suspected, initial encounter
  • T76.92XD — Unspecified child maltreatment, suspected, subsequent encounter
  • T76.92XS — Unspecified child maltreatment, suspected, sequela
  • T76.A — Financial abuse, suspected
  • T76.A1 — Adult financial abuse, suspected
  • T76.A1XD — Adult financial abuse, suspected, subsequent encounter
  • T76.A1XS — Adult financial abuse, suspected, sequela
  • T76.A2 — Child financial abuse, suspected
  • T76.A2XA — Child financial abuse, suspected, initial encounter
  • T76.A2XD — Child financial abuse, suspected, subsequent encounter

View all codes in the T76 family