New ICD-10-CM codes for abuse and neglect available April 1

The Centers for Disease Control and Prevention (CDC) has added new ICD-10-CM diagnosis codes for maltreatment, neglect, financial abuse, and social determinants of health (SDOH), effective April 1.

The new codes related to financial abuse of a patient are in ICD-10-CM chapter 19: Injury, Poisoning, and Certain Other Consequences of External Causes (S00-T88):

• T74.A1, “Adult financial abuse, confirmed”
• T74.A2, “Child financial abuse, confirmed”
• T76.A1, “Adult financial abuse, suspected”
• T76.A2, “Child financial abuse, suspected”

To give the full code, add an “X” place marker in the sixth character position of the above codes, then assign a seventh character of “A” for the initial encounter involving the condition, “D” for subsequent encounters, and “S” for an encounter involving the condition’s sequela (e.g., T74.A1XA, “Adult financial abuse, confirmed, initial encounter”).

In ICD-10-CM chapter 20: External Causes of Morbidity (V00-Y99), you’ll find new, more specific codes related to maltreatment and neglect of a patient. An expanded code set for Y07.0- allows you to describe the perpetrator as either a current or former spouse/partner (e.g., Y07.020, “Wife, current, perpetrator of maltreatment and neglect”) and new codes starting with Y07.4- allow you to describe mistreatment by other specific family members (e.g., Y07.46, “Grandparent, perpetrator of maltreatment and neglect”). You’ll also be able to document mistreatment by people outside the patient’s family by using new code Y07.54, “Acquaintance or friend, perpetrator of maltreatment and neglect.”

The remaining new codes are related to SDOH, and can be found in ICD-10-CM chapter 21: Factors Influencing Health Status and Contact with Health Services (Z00-Z99). These new codes address patient problems related to education and literacy (Z55-), physical environment (Z58-), housing and economic circumstance (Z59-), personal history of abuse in childhood (Z62.81-), and patient noncompliance (Z91.1-). These codes also allow for a greater degree of specificity. For example, code Z59.1 is the existing code for inadequate housing, and now Z59.11 has been added for inadequate housing due to environmental temperature. 

Complete information on the April 1 update is available on the CDC website.

— Kent Moore, AAFP Senior Strategist for Physician Payment

Posted on March 7, 2023