T76
Non-Billable (Header)Adult and child abuse, neglect and other maltreatment, suspected
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
What This Code Means
T76 is the ICD-10-CM diagnosis code for adult and child abuse, neglect and other maltreatment, suspected. T76 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 T76 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 T76'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 T76 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Excludes 1 — Do NOT code together
- adult and child maltreatment, confirmed (T74.-)
- suspected abuse and maltreatment in pregnancy (O9A.3-, O9A.4-, O9A.5-)
- suspected adult physical abuse, ruled out (Z04.71)
- suspected adult sexual abuse, ruled out (Z04.41)
- suspected child physical abuse, ruled out (Z04.72)
- suspected child sexual abuse, ruled out (Z04.42)
Use Additional Code
- code, if applicable, to identify any associated current injury