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T74

Non-Billable (Header)

Adult and child abuse, neglect and other maltreatment, confirmed

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

What This Code Means

T74 is the ICD-10-CM diagnosis code for adult and child abuse, neglect and other maltreatment, confirmed. T74 sits in the ICD-10-CM chapter for injury, poisoning and certain other consequences of external causes (s00-t88), within the section covering other and unspecified effects of external causes (t66-t78).

Header codes like T74 cannot be reported on claims directly — they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at T74's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for T74 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1 — Do NOT code together

  • abuse and maltreatment in pregnancy (O9A.3-, O9A.4-, O9A.5-)
  • adult and child maltreatment, suspected (T76.-)

Use Additional Code

  • code, if applicable, to identify any associated current injury
  • external cause code to identify perpetrator, if known (Y07.-)

Child Codes

Code Hierarchy

T74Adult and child abuse, neglect and other maltreatment, confirmed
T74Adult and child abuse, neglect and other maltreatment, confirmed

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