icd 10 code for status post gender reassignment

What is the ICD 10 code for gender reassignment surgery?

And for revised code F64.1, ICD-10 instructs you to “Use additional code to identify sex reassignment status (Z87.890).” Question: “ Should I identify a patient as transgender if it doesn’t pertain to the services being rendered?”

What is the ICD 10 code for gender identity disorder?

Gender identity disorder, unspecified. F64.9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2019 edition of ICD-10-CM F64.9 became effective on October 1, 2018.

What are the ICD-10 codes for Transgender Health Services?

When in doubt, consult the payer. BlueCross BlueShield (BCBS) of Nebraska advises, “When applicable, include the appropriate transgender ICD-10 codes (F64.x) as secondary information on claims for all services, including mental health and primary care services.”

What is the ICD 10 code for personal history of reassignment?

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 Note that ICD-10 still uses the outdated terms of gender identity disorder and transsexualism. However, changes are coming for ICD-11, and the five diagnoses codes will be replaced by two gender incongruence codes.

How do you code gender reassignment?

ICD-10-CM Diagnosis Codes 9 may be used to describe the type of gender dysphoria diagnosed. 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 Note that ICD-10 still uses the outdated terms of gender identity disorder and transsexualism.

What is the ICD-10 code for status post surgery?

ICD-10-CM Code for Encounter for surgical aftercare following surgery on specified body systems Z48. 81.

What is diagnosis code F64 9?

Gender identity disorder, unspecified9: Gender identity disorder, unspecified.

What is diagnosis code R29 818?

R29. 818 - Other symptoms and signs involving the nervous system | ICD-10-CM.

What is the ICD 10 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 does diagnosis code Z98 890 mean?

Other specified postprocedural states2022 ICD-10-CM Diagnosis Code Z98. 890: Other specified postprocedural states.

What does F43 23 mean?

Code F43. 23 is the diagnosis code used for Adjustment Disorder (AD) with Mixed Anxiety and Depressed Mood. It is sometimes known as situational depression. It occurs when an individual is unable to adjust to or cope with a particular stress or a major life event.

What is ICD 10 code for gender dysphoria?

F64. 9 Gender identity disorder, unspecified.

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 is the ICD-10 code for altered mental status?

82 Altered mental status, unspecified.

What is the ICD-10 code for incontinence?

Incontinence without sensory awareness N39. 42 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 N39. 42 became effective on October 1, 2021.

What is the ICD-10 code for generalized weakness?

ICD-10 | Muscle weakness (generalized) (M62. 81)

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 ...

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 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 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.

When was transgender health first published?

1979 – The first standards of care for transsexuals were published by the Harry Benjamin International Gender Dysphoria Association, now known as the World Professional Association of Transgender Health. 1980 – Transsexualism was included in the third edition of the DSM (DSM-III).

Why is gender reassignment surgery important?

It is important to review each policy for coverage and limitations, to get prior authorization, and to ensure that medical documentation supports the services billed.

What percentage of people with gender dysphoria go undiagnosed?

Approximately 71 percent of individuals who go undiagnosed or untreated for gender dysphoria will be diagnosed with conditions such as mood disorder, anxiety disorder, schizophrenia, depression, substance abuse, eating disorder, or suicide attempt. Treatment.

How to help someone with gender dysphoria?

It is not to change how the person feels about his or her gender. Talk therapy can help; and medications, such as puberty blockers and hormones, can change the appearance.

How long does it take for a teen to have gender dysphoria?

A teen or adult may be diagnosed with gender dysphoria when the condition is experienced for at least 6 months and displays in two or more of the following: Believing that his/her gender is not in line with his/her body.

Why is it so hard to determine the number of transgender people in the U.S.?

due to social stigma, discrimination, harassment, and physical and sexual abuse.

What happens when you have a gender mismatch?

This feeling of gender mismatch can cause major distress, anxiety, and depression, which can affect a person's everyday life.

What is the procedure 55970?

55970 - (Intersex surgery; male to female) involves the following staged procedures to remove portions of the male genitalia and form female external genitals: Penis is dissected, and portions are removed with care to preserve vital nerves and vessels in order to fashion a clitoris-like structure.

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:

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 ...

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.