ICD-10 Coding for Assault(T74.12XA, Y07.03)
Complete ICD-10-CM coding and documentation guide for Assault. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Assault
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 | Adult physical abuse, confirmed, initial encounter | Use when abuse is confirmed by a healthcare provider or legal authority. |
|
| Y07.03 | Perpetrator of maltreatment and neglect, male partner | Use when the perpetrator is identified as a male partner. |
|
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 assault
Essential facts and insights about Assault
Primary ICD-10-CM Codes for assault
Decision Criteria
documentation Criteria
- Explicit confirmation of abuse in the medical record
Applicable To
- Confirmed adult physical abuse
Excludes
- Suspected adult physical abuse (T76.12XA)
Clinical Validation Requirements
- Documented confirmation of abuse by clinical or legal evaluation
- Corroborating evidence such as police or CPS reports
Code-Specific Risks
- Misclassification if documentation does not explicitly confirm abuse
Coding Notes
- Ensure documentation clearly states 'confirmed' abuse to use this code.
Y07.03 - Perpetrator of maltreatment and neglect, male partner
Use when the perpetrator is identified as a male partner.
Applicable To
- Assault by male partner
Excludes
- Assault by female partner (Y07.02)
Clinical Validation Requirements
- Documentation of the perpetrator's relationship to the victim
Coding Notes
Ensure the relationship is clearly documented in the patient's record.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Assault by striking with fist, initial encounter
Y04.2XXADifferential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Adult physical abuse, suspected, initial encounter
T76.12XADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Assault to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code T74.12XA.
Impact
Clinical: Incomplete clinical picture, Regulatory: Non-compliance with coding standards, Financial: Potential for denied claims
Mitigation Strategy
Always ask and document the relationship of the perpetrator, Use structured templates for assault cases
Impact
Reimbursement: Incorrect sequencing can lead to reduced reimbursement., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate data on abuse cases.
Mitigation Strategy
Always sequence T74.1- codes first when abuse is confirmed.
Impact
Improper sequencing can lead to audit flags and reimbursement issues.
Mitigation Strategy
Train staff on correct sequencing rules for abuse cases.
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, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Assault
Use these documentation templates to ensure complete and accurate documentation for Assault. These templates include all required elements for proper coding and billing.
Emergency Department Visit for Assault
Specialty: Emergency MedicineRequired Elements
- Patient history
- Physical examination findings
- Confirmation of abuse
- Injury details
- Perpetrator information
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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