T76.22XA: Child sexual abuse, suspected, initial encounter
T76.22XA, child sexual abuse, suspected, initial encounter, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 4 HCPCS Level II codes, including G0451 (Development testing, with interpretation and report, per…), G0017 (Psychotherapy for crisis furnished in an applicable site…), G0018 (Psychotherapy for crisis furnished in an applicable site…). The articles come from 3 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with T76.22XA as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0451 | Development testing, with interpretation and report, per standardized instrument form | Carrier judgment | — | 3 |
| G0017 | Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes | Carrier judgment | — | 1 |
| G0018 | Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service) | Carrier judgment | — | 1 |
| G0560 | Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employing internal coping strategies; utilizing social contacts and social settings as a means of distraction from suicidal thoughts or risky substance use; utilizing family members, significant others, caregivers, and/or friends to help resolve the crisis; contacting mental health or substance use disorder professionals or agencies; and making the environment safe | Carrier judgment | — | 1 |
Medicare policy articles listing T76.22XA
- A56937: Billing and Coding: Psychiatry and Psychology Services (Wellpoint Federal (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33632, L34616
- A57130: Billing and Coding: Psychiatric Codes (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 4 Level II codes). LCD with the same title: L35101
- A57780: Billing and Coding: Psychological and Neuropsychological Tests (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34520
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other T76 diagnoses (Adult and child abuse, neglect and other maltreatment, suspected)
- T76.21XA — Adult sexual abuse, suspected, initial encounter
- T76.01XA — Adult neglect or abandonment, suspected, initial encounter
- T76.02XA — Child neglect or abandonment, suspected, initial encounter
- T76.11XA — Adult physical abuse, suspected, initial encounter
- T76.12XA — Child physical abuse, suspected, initial encounter
- T76.51XA — Adult forced sexual exploitation, suspected, initial encounter
Frequently asked questions
Does Medicare cover T76.22XA (Child sexual abuse, suspected, initial encounter)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list T76.22XA as a covered diagnosis for 4 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 T76.22XA?
The Level II codes from the policies most specific to this diagnosis are G0451 (Development testing, with interpretation and report, per…, 3 articles); G0017 (Psychotherapy for crisis furnished in an applicable site…, 1 article); G0018 (Psychotherapy for crisis furnished in an applicable site…, 1 article); G0560 (Safety planning interventions, each 20 minutes personally…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list T76.22XA?
A56937 (Billing and Coding: Psychiatry and Psychology Services); A57130 (Billing and Coding: Psychiatric Codes); A57780 (Billing and Coding: Psychological and Neuropsychological Tests).
What is ICD-10-CM code T76.22XA?
T76.22XA is the ICD-10-CM code for child sexual abuse, suspected, initial encounter, in category T76 (Adult and child abuse, neglect and other maltreatment, suspected), chapter 19: Injury, poisoning and other consequences of external causes.
Next steps
- Run a reimbursement report for a device billed under G0451
- Watch G0451 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0451
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 19: Injury, poisoning and other consequences of external causes · All diagnoses · HCPCS lookup