ICD-10 Coding for Domestic Violence(T74.11XA, Z63.0)
Complete ICD-10-CM coding and documentation guide for Domestic Violence. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Domestic Violence
T74.1-T74.9Primary Range
Adult and child abuse, neglect and other maltreatment, confirmed
This range includes confirmed cases of physical, sexual, and psychological abuse, as well as neglect and other maltreatment.
Adult and child abuse, neglect and other maltreatment, suspected
This range is used for suspected cases where abuse has not been confirmed.
Perpetrator of maltreatment and neglect
These codes identify the relationship of the perpetrator to the victim.
Problems in relationship with spouse or partner
These codes are used for relationship problems impacting health, not direct abuse.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| T74.11XA | Adult physical abuse, confirmed, initial encounter | Use when physical abuse is confirmed by clinical evaluation or social work assessment. |
|
| Z63.0 | Problems in relationship with spouse or partner | Use for relationship issues impacting health without confirmed abuse. |
|
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 domestic violence
Essential facts and insights about Domestic Violence
Primary ICD-10-CM Codes for domestic violence
Decision Criteria
clinical Criteria
- Presence of injuries consistent with abuse and corroboration by social services.
Applicable To
- Confirmed physical abuse by intimate partner
Excludes
- Suspected physical abuse (T76.11XA)
Clinical Validation Requirements
- Corroborating witness or social worker note
- Injury inconsistent with history
- Perpetrator admission
Code-Specific Risks
- Incorrectly using without confirmation of abuse
Coding Notes
- Ensure documentation explicitly states 'confirmed' abuse and includes perpetrator details.
Z63.0 - Problems in relationship with spouse or partner
Use for relationship issues impacting health without confirmed abuse.
Applicable To
- Marital conflict impacting health
Excludes
- Confirmed abuse (T74.-)
Clinical Validation Requirements
- Documentation of relationship stress affecting health
Coding Notes
Ensure documentation reflects relationship issues without abuse.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Perpetrator of maltreatment and neglect, male intimate partner
Y07.03Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Domestic Violence to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code T74.11XA.
Impact
Clinical: Misrepresentation of the nature of the injury., Regulatory: Potential for audit issues., Financial: Incorrect reimbursement rates.
Mitigation Strategy
Ensure documentation specifies relationship to perpetrator, Use Y07.- codes for perpetrator details
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on abuse prevalence.
Mitigation Strategy
Use T74.- for confirmed cases and T76.- for suspected cases only.
Impact
Lack of detailed documentation can lead to audit flags.
Mitigation Strategy
Ensure comprehensive documentation including patient statements and corroborating evidence.
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 Domestic Violence, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Domestic Violence
Use these documentation templates to ensure complete and accurate documentation for Domestic Violence. These templates include all required elements for proper coding and billing.
Emergency Department Visit for Domestic Violence
Specialty: Emergency MedicineRequired Elements
- Patient's statement
- Perpetrator relationship
- Injury details
- Social work involvement
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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