icd 10 code for female to male transgender

by Ezra Walker 9 min read

Personal history of sex reassignment
Z87. 890 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z87. 890 became effective on October 1, 2021.

How to code hormone replcament for transgender ICD 10?

Oct 01, 2021 · 2022 ICD-10-CM Diagnosis Code F64.9 2022 ICD-10-CM Diagnosis Code F64.9 Gender identity disorder, unspecified 2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code F64.9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

How many codes in ICD 10?

Oct 01, 2021 · F64.0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM F64.0 became effective on October 1, 2021. This is the American ICD-10-CM version of F64.0 - other international versions of ICD-10 F64.0 may differ. Applicable To.

What are ICD-10 diagnostic codes?

Gender identity disorders ( F64) F64.0 is a billable diagnosis code used to specify a medical diagnosis of transsexualism. The code F64.0 is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions. The ICD-10-CM code F64.0 might also be used to specify conditions or terms like adult gender identity …

What is the ICD 10 code for transgender female?

Oct 01, 2015 · When reporting procedure code 55970 (Intersex surgery; male to female), the following staged procedures to remove portions of the male genitalia and form female external genitals are included: The penis is dissected, and portions are removed with care to preserve vital nerves and vessels in order to fashion a clitoris-like structure.

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What is the ICD-10 code for gender reassignment?

Z87.8901, ICD-10 instructs you to “Use additional code to identify sex reassignment status (Z87. 890).”Nov 15, 2016

How do you code gender reassignment?

ICD-10-CM Diagnosis Codes There is also a status code for personal history of sex reassignment (Z87. 890). Note that ICD-10 still uses the outdated terms of gender identity disorder and transsexualism.May 1, 2018

What is diagnosis code Z98 890?

Other specified postprocedural statesICD-10 code Z98. 890 for Other specified postprocedural states is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .

What is diagnosis code F64 9?

Gender identity disorder, unspecifiedICD-10 code F64. 9 for Gender identity disorder, unspecified is a medical classification as listed by WHO under the range - Mental, Behavioral and Neurodevelopmental disorders .

What does condition code 45 mean?

Ambiguous Gender CategoryPolicy: For Part A claims processing, institutional providers shall report condition code 45 (Ambiguous Gender Category) on any outpatient claim related to transgender or hermaphrodite issues.Dec 18, 2009

What is procedure code 55970?

The Current Procedural Terminology (CPT®) code 55970 as maintained by American Medical Association, is a medical procedural code under the range - Intersex Surgery.

What is Z47 89?

ICD-10 code Z47. 89 for Encounter for other orthopedic aftercare is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .

What is G89 29 diagnosis?

ICD-10 | Other chronic pain (G89. 29)

What is the ICD-10 code for other specified Postprocedural States?

Z98.890Other specified postprocedural states Z98. 890 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

What is dual role transvestism?

“Dual role transvestism” appears in research review, and is essentially defined as an individual, usually male, who wears clothes of the opposite sex in order to experience temporary membership in the opposite sex, has no sexual motivation for the cross-dressing, and no desire for a permanent change to the opposite sex ...Sep 10, 2019

What is the DSM-5 code for gender dysphoria?

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What does anxiety F41 9 mean?

Code F41. 9 is the diagnosis code used for Anxiety Disorder, Unspecified. It is a category of psychiatric disorders which are characterized by anxious feelings or fear often accompanied by physical symptoms associated with anxiety.

What are the codes for gender dysphoria?

Although there is no specific procedure code for people diagnosed with gender dysphoria who are choosing to transition, there are two CPT® codes that pertain to intersex surgery:#N#55970 Intersex surgery; male to female#N#55980 Intersex surgery; female to male#N#Codes 55970 and 55980 apply to surgery for newborns with ambiguous genitalia, as well.#N#Although not a comprehensive list, here are common procedures performed during gender transition surgery:#N#Vaginectomy (FTM) – Look to codes such as 58275 Vaginal hysterectomy, with total or partial vaginectomy, 57111 Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy), etc.#N#Urethroplasty (MTF and FTM) – Look to applicable CPT® codes 53410 – 53430.#N#Phalloplasty (FTM) – 55899 Unlisted surgery of the male genital system, for metoidioplasty and phalloplasty#N#Scrotoplasty (MTF) – 55175 Scrotoplasty; simple and 55180 Scrotoplasty; complicated#N#Penectomy (MTF) – 54125 Amputation of penis; complete#N#Vaginoplasty (MTF) – 57335 Vaginoplasty for intersex state#N#Labiaplasty (MTF) – 56625 Vulvectomy simple; complete#N#Clitoroplasty (MTF) – 56805 Clitoroplasty for intersex state#N#There are also surgical procedures associated with intersex surgery that payers typically consider to be cosmetic:#N#Abdominoplasty – 15830 Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy#N#Blepharoplasty – 15822 Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)#N#Otoplasty – 69300 Otoplasty, protruding ear, with or without size reduction#N#Rhinoplasty – 30410 Rhinoplasty, primary; complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip#N#Genioplasty – 21120 Genioplasty; augmentation (autograft, allograft, prosthetic material)#N#Rhytidectomy – 15828 Rhytidectomy; cheek, chin, and neck

What is transgender medical?

Transgender is a broad term used for people whose gender identity or gender expression differs from their assigned sex at birth. Proper diagnosis and procedural coding of transgender medical services begins with understanding the spectrum of gender identity variations.

How does gender dysphoria manifest?

Gender dysphoria is manifested in a variety of ways, including a strong desire to be treated as the other gender or to be rid of sex characteristics, or a strong conviction that the patient has feelings and reactions typical of the other gender.

How long does gender dysphoria last?

For a person to be diagnosed with gender dysphoria, there must be a marked difference between the individual’s expressed/experienced gender and the gender others would assign to him or her, and it must continue for at least six months. In children, the desire to be of the other gender must be verbalized.

What does FTM mean?

Female-to-male (FTM) — Someone who was identified as female at birth but identifies and portrays his gender as male. This term is often used after the individual has taken some steps to express his gender as male, or after medically transitioning through hormones or surgery (aka, transman).

What is the difference between gender identity and intersex identity?

Gender identity — A person’s innate identification as a man, woman, or something else that may (or may not) correspond to the person’s external body or assigned sex at birth. Intersex — Individuals with a set of congenital variations of the reproductive system that are not considered typical for either male or female.

When were gender identity centers established?

1960-1970 – Gender identity centers were established at Johns Hopkins, Stanford University, and the University of Minnesota, which legitimized the care and diagnosis of transgender individuals. 1973 – Burou had performed over 3,000 MTF operations by 1973.

What is the meaning of transsexualism?

TRANSSEXUALISM-. expression of a gender identity inconsistent with or not culturally associated with the gender assigned to an individual at birth combined with the desire to permanently transition to the gender with which they identify.

What is the F64.0 code?

Valid for Submission. F64.0 is a billable diagnosis code used to specify a medical diagnosis of transsexualism. The code F64.0 is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions.

What is gender dysphoria?

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) refers to this as “gender dysphoria.”. “It is important to note,” DSM-5 states, “that gender nonconformity is not in itself a mental disorder. The critical element of gender dysphoria is the presence of clinically significant distress associated with ...

What is the Joint Commission's recommendation for gender identity data?

The Joint Commission and others have recommended that gender identity data be routinely collected in healthcare settings. “From a clinical standpoint,” the authors of the transgender healthcare guide write, “collecting this data is essential to providing high-quality care to transgender patients.”#N#They also recommend hospitals adopt admitting/registration procedures that enable transgender patients to designate their gender identity and name in use, even when this identity differs from how their medical insurance or legal documents identify them.#N#The authors of the guide propose the follow-ing admitting/registration procedures:

How long does gender dysphoria last?

According to DMS-5, “For a person to be diagnosed with gender dysphoria, there must be a marked difference between the individual’s expressed/experienced gender and the gender others would assign him or her, and it must continue for at least six months.

Why is it important to record gender?

This information is important because it tells a doctor to offer preventive screening appropriate to the patient’s anatomy.

Can a transgender man have a uterus?

For example, a transgender man may still have a uterus and require gynecological exams. Providers are generally able to reverse gender-related denials, but not without both the provider and patient being inconvenienced. The Centers for Medicare & Medicaid Services (CMS) already thought of this.

Does Medicare cover hormone therapy?

Medicare covers medically necessary hormone therapy and sex reassignment, as well as routine preventive care, regardless of gender markers. CMS advises institutional providers to use claim level condition code 45 Ambiguous gender category to identify such claims that pose a gender/procedure conflict.

Is transgender status protected under HIPAA?

A patient’s transgender status or history of transition-related procedures may constitute protected health information under the HIPAA Privacy Rule. Providers should develop, implement, and train staff on the organization’s privacy policy regarding this matter. Resources.

General Information

CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

Article Guidance

Gender Dysphoria (GD) is defined by the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition, DSM-5™ as a condition characterized by the "distress that may accompany the incongruence between one’s experienced or expressed gender and one’s assigned gender" also known as “natal gender”, which is the individual’s sex determined at birth.

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.

What is the ICd 9 code for transsexual?

Covered diagnoses in ICD-9-CM include: 302.50 – Trans-sexualism with unspecified sexual history. 302.51 – Trans-sexualism with asexual history.

What is the code for intersex surgery?

Many of the policies do not accept the codes 55970 Intersex surgery; male to female or 55980 Intersex surgery; female to male. Rather, they require that the claim be filed with the CPT code that represents the specific procedure. For example, for male-to-female surgery the following may be coded: Orchiectomy (54520, 54690) Penectomy (54125)

How old do you have to be to get a gd?

The individual must be at least 18 years of age; The individual must be diagnosed with GID or GD; The individual must have successfully lived and worked with the desired gender role full-time for at least 12 months to two years (depending on policy/insurance) without returning to the original gender; Gender reassignment surgery must be ...

Does Medicare cover gender reassignment surgery?

Most major insurance, including Medicare, cover gender reassignment surgery under very specific guidelines. Though there are many similarities in the medical policies for gender reassignment surgery among the various major insurance companies, if the provider you work for is providing this service, you will need to find ...

What is the ICd 10 code for transsexualism?

You might consider using diagnosis code F64.0, Transsexualism, in addition to an appropriately leveled Evaluation and Management (E/M) code. Please note that per ICD-10-CM inclusive notes for F64.0, code F64.0 covers both “gender identity disorder in adolescence and adulthood” and “gender dysphoria in adolescents and adults.”

What is condition code 45?

Per the CMS Transmittal, condition code 45, Ambiguous Gender Category, needs to be reported on Part A Medicare claims to identify transgender- or hermaphrodite-related cases. The presence of this condition code on your claim will allow sex-related edits to be bypassed so your claim can be processed like other regular Medicare claims.

What is the definition of transgender?

Transgender – definitions vary, however “transgender” generally refers to a gender identity or gender expression that differs from an individual’s assigned sex, or natal gender. Of note: The term “Transgender” isn’t included in any of the ICD-10-CM code descriptors, and “Transgender” is not a term found in the Index.

What is gender identity?

Gender identity – defined in DSM-5 as “…a category of social identity and refers to an individual’s identification as male, female, or occasionally, some category other than male or female.”. It cannot be assumed that these patients have a gender identity disorder/gender dysphoria.

What is code F64?

Code F64.1 is the only code in code category F64 that includes this instruction note, but that does not prohibit reporting Z87.890 for any applicable cases. F64.2 Gender identity disorder of childhood includes “gender dysphoria in children.”.

What is the closest diagnosis to DSM-5?

The closest that DSM-5 comes to this term or diagnosis is “transvestic disorder.”. It appears in the chapter “Paraphylic Disorders,” not the chapter “Gender Dysphoria.”. Paraphilic disorders include voyeuristic disorder, exhibitionistic disorder, sexual masochism, pedophilia, and transvetic disorder. Transvestic disorder is defined as “engaging in ...

What is an "other diagnosis"?

For reporting purposes, the definition for “other diagnoses” is interpreted as additional conditions that affect patient care in terms of requiring: clinical evaluation; or therapeutic treatment; or diagnostic procedures; or extended length of hospital stay; or increased nursing care and/or monitoring.

Can a diagnosis be assigned prior to puberty?

The diagnosis cannot be assigned prior the onset of puberty. Gender variant behavior and preferences alone are not a basis for assigning the diagnosis. “Transsexual” and “trans-sexualism” are inclusion terms for code HA60.

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