T76.22XAChild sexual abuse, suspected, initial encounter

T76.22XA is the ICD-10-CM diagnosis code for child sexual abuse, suspected, initial encounter. It belongs to category T76 (adult and child abuse, neglect and other maltreatment, suspected), block T66-T78 (other and unspecified effects of external causes) and chapter 19 (injury, poisoning and certain other consequences of external causes). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

The 7th character "A" means initial encounter: use it while the patient is receiving active treatment for the condition.

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

As a secondary diagnosis it is a CC (complication or comorbidity), which can move an inpatient stay into the "with CC" MS-DRG of its family, unless the principal diagnosis excludes it.

In MS-DRG v44.0, it is part of the grouping logic for DRG 922 (Other Injury, Poisoning and Toxic Effect Diagnoses with MCC, relative weight 1.6238) and DRG 923 (Other Injury, Poisoning and Toxic Effect Diagnoses without MCC, relative weight 0.9973), in MDC 21 (Injuries, Poisonings and Toxic Effects of Drugs), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

The Medicare Code Editor expects this diagnosis only for patients age 0 through 17; other ages trigger an age-conflict edit.

It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.

Before ICD-10, this condition was coded in ICD-9-CM as 995.53 (child sexual abuse).