Child Abuse diagnosed as an adult


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Our PA recently saw a 54 year old women who recently discovered that she was sexually abused as a child for approximately two years. The PA coded the note with T74.22XA (Confirmed victim of sexual abuse in childhood, initial encounter) since the diagnosis was new to the patient's chart and to the patient. The diagnosis is invalid due to the patient's age. Does anyone know what the appropriate diagnosis code would be in this situation?

Here are the chart notes:

She was raped at age 7 on 12/24 for the first time. A man that lived down the street came to her house and wanted to show her and he sister something out in the barn. He tied them up. She and her sister were raped in front of each other. They were hit, knocked out. Her brother, who was 9, found them later. The man threatened to hurt her mom, her family, burn the house down so they were scared and didn't tell anyone.
- She was repeatedly raped for 2 years.
- Perpetrator has since died, was in federal prison.
- Working through the remaining anger, feelings from this trauma - that it's not her fault

Thanks for the help!


True Blue
Columbia, MO
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Since the patient is not being treated for the sexual abuse it would not be initial. It appears that the patient is being treated for anger issues due to the abuse. This would be sequela of the abuse not initial. Code the anger first listed and then the T code with S as the seventh character. Since there is no time limit on sequela the age should not be an issue.