ICD-10 Coding for Physical Assault(T74.11XA, T76.12XA)
Complete ICD-10-CM coding and documentation guide for Physical Assault. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Physical 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 |
|---|---|---|---|
| T74.11XA | Confirmed adult physical abuse, initial encounter | Use when abuse is confirmed by clinical or legal evidence. |
|
| T76.12XA | Suspected child physical abuse, initial encounter | Use when abuse is suspected but not confirmed. |
|
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 physical assault
Essential facts and insights about Physical Assault
Primary ICD-10-CM Codes for physical assault
Decision Criteria
clinical Criteria
- Confirmed abuse through clinical evaluation or legal report
Applicable To
- Confirmed physical abuse
Excludes
- Suspected physical abuse (T76.11XA)
Clinical Validation Requirements
- Provider documentation of confirmed abuse
- Corroborating evidence such as witness statements or legal determination
Code-Specific Risks
- Incorrectly coding as suspected abuse when confirmed
- Failure to document corroborating evidence
Coding Notes
- Ensure documentation clearly states the abuse is confirmed.
T76.12XA - Suspected child physical abuse, initial encounter
Use when abuse is suspected but not confirmed.
Applicable To
- Suspected physical abuse
Excludes
- Confirmed physical abuse (T74.12XA)
Clinical Validation Requirements
- Inconsistent history or delayed care
- High-risk social context
Coding Notes
Ensure documentation supports the suspicion of abuse.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Physical Assault to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code T74.11XA.
Impact
Clinical: May lead to incorrect diagnosis and treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Use specific language to describe injuries., Include corroborating evidence when available.
Impact
Reimbursement: Incorrect sequencing can lead to improper DRG assignment., Compliance: May result in audit discrepancies., Data Quality: Affects the accuracy of abuse statistics.
Mitigation Strategy
Always code the abuse as primary, followed by injury codes.
Impact
Reimbursement: May affect reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on confirmed abuse cases.
Mitigation Strategy
Ensure documentation clearly states the abuse is confirmed.
Impact
Using suspected codes for confirmed cases or vice versa.
Mitigation Strategy
Regular training on documentation and coding guidelines.
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 Physical Assault, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Physical Assault
Use these documentation templates to ensure complete and accurate documentation for Physical Assault. These templates include all required elements for proper coding and billing.
Emergency Department Evaluation for Assault
Specialty: Emergency MedicineRequired Elements
- Patient history
- Physical examination findings
- Diagnostic conclusions
- Confirmation of abuse
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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