ICD-10 Coding for Assault by Another Person(T74.12XA, Y04.2XXA)
Complete ICD-10-CM coding and documentation guide for Assault by Another Person. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Assault by Another Person
T74-T76Primary Range
Adult and child abuse, neglect and other maltreatment, confirmed or suspected
This range includes codes for confirmed and suspected cases of abuse, which are primary for documenting assault cases.
Assault
This range provides codes for the mechanism of assault, which are used as secondary codes.
Perpetrator of maltreatment and neglect
These codes identify the relationship of the perpetrator to the victim, used in confirmed cases.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| T74.12XA | Child physical abuse, confirmed, initial encounter | Use when child abuse is confirmed by a provider statement. |
|
| Y04.2XXA | Assault by strike or bump, initial encounter | Use as a secondary code to specify the mechanism of assault. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for confirmed child abuse
Essential facts and insights about Assault by Another Person
Primary ICD-10-CM Codes for assault by another person
Decision Criteria
clinical Criteria
- Confirmed abuse by provider statement
Applicable To
- Confirmed child physical abuse
Excludes
- Suspected child physical abuse (T76.12XA)
Clinical Validation Requirements
- Provider documentation confirming abuse
- Radiological evidence of non-accidental trauma
Code-Specific Risks
- Misclassification if abuse is not confirmed
Coding Notes
- Ensure documentation explicitly states 'confirmed' abuse.
Y04.2XXA - Assault by strike or bump, initial encounter
Use as a secondary code to specify the mechanism of assault.
Applicable To
- Assault by striking or bumping
Excludes
- Accidental bumping (W50.2XXA)
Clinical Validation Requirements
- Documentation of assault mechanism
Coding Notes
Ensure the mechanism of assault is clearly documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Assault by strike or bump, initial encounter
Y04.2XXADifferential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Child physical abuse, suspected, initial encounter
T76.12XADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Assault by Another Person to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code T74.12XA.
Impact
Clinical: Misrepresentation of patient condition, Regulatory: Potential audit issues, Financial: Incorrect billing and reimbursement
Mitigation Strategy
Verify provider documentation before coding, Use suspected abuse codes when confirmation is pending
Impact
Reimbursement: Incorrect DRG assignment leading to potential overpayment, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate data representation of abuse cases
Mitigation Strategy
Ensure provider documentation confirms abuse before coding.
Impact
High risk of audit if abuse is coded without proper confirmation.
Mitigation Strategy
Ensure all cases of abuse are supported by clear provider documentation.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Assault by Another Person, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Assault by Another Person
Use these documentation templates to ensure complete and accurate documentation for Assault by Another Person. These templates include all required elements for proper coding and billing.
Emergency Department Assault Case
Specialty: Emergency MedicineRequired Elements
- Patient's account of the incident
- Detailed description of injuries
- Provider's assessment and confirmation of abuse
- Documentation of any referrals (e.g., CPS)
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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