icd 10 code for transgender female

How to code hormone replcament for transgender ICD 10?

Oct 01, 2021 · Transsexualism. 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.

How many codes in ICD 10?

Oct 01, 2021 · F64.9 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 F64.9 became effective on October 1, 2021. This is the American ICD-10-CM version of F64.9 - other international versions of ICD-10 F64.9 may differ. Applicable To Gender dysphoria, unspecified

What are ICD-10 diagnostic codes?

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 disorder, sexually attracted to …

What is the ICD 10 code for transgender female?

Use code Z87.890 Personal history of sex reassignment for sex reassignment surgery (SRS) status. Procedural Coding 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: 55970 Intersex surgery; male to female

What is the ICD-10-CM code for gender dysphoria?

F64.9Gender 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 2022 edition of ICD-10-CM F64. 9 became effective on October 1, 2021.

How do you code gender reassignment?

This ensures treatment access for individuals who continue to undergo hormone therapy, related surgery, or psychotherapy or counseling to support their gender transition. Use code Z87. 890 Personal history of sex reassignment for sex reassignment surgery (SRS) status.Jun 6, 2018

What is the CPT code for gender dysphoria?

Coding, CPT, 55970, 55980.May 1, 2018

What is diagnosis code F64 9?

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

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.

How is gender dysphoria diagnosis?

Your health care provider might make a diagnosis of gender dysphoria based on: Behavioral health evaluation. Your provider will evaluate you to confirm the presence of gender dysphoria and document how prejudice and discrimination due to your gender identity (minority stress factors) impact your mental health.Feb 26, 2022

What is procedure code 19303?

To summarize, report code 19303 for a skin-sparing or nipple-sparing mastectomy for diagnosed carcinoma or for patients who are at high risk for carcinoma, regardless of the amount of skin removed or whether the nipple is preserved.Mar 1, 2017

What is the CPT code for labiaplasty?

Labiaplasty, or labia reduction (Current Procedural Terminology [CPT] codes 15839 or 56620), is a surgical procedure that removes tissue from the labia, and/or reshapes the labia. The procedure may be performed for asymmetrical, enlarged, or hypertrophic labia minora and/or labia majora.

What is the difference between F64 0 and F64 1?

ICD-10 notes that new code F64. 0 covers both “Gender identity disorder in adolescence and adulthood” and “Gender dysphoria in adolescents and adults.” And for revised code F64. 1, ICD-10 instructs you to “Use additional code to identify sex reassignment status (Z87.Nov 15, 2016

What is the ICD 10 code for gender reassignment?

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.

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 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

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.

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).

Who is Michelle Dick?

Michelle Dick. Michelle A. Dick, BS, is a freelance content specialist, providing writing, editorial expertise, and graphic imagery to clients. Prior to becoming a free agent, she was an executive editor for AAPC, editor-in-chief at Eli Research, and editor at Element K Journals.

What is intersex in biology?

Intersex — Individuals with a set of congenital variations of the reproductive system that are not considered typical for either male or female. This includes newborns with ambiguous genitalia, a condition that affects one in 2,000 newborns in the United States each year.

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.

Is there a definition of transgender?

Although there is no universally accepted definition of the word “transgender,” here are some terms you should know when coding patients with gender dysphoria: Bigendered — Individuals who identify as both or alternatively male and female, as no gender, or as a gender outside the male or female binary.

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.

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 should staff be trained on?

Training — Staff should be trained on how to collect gender identification and how it should be recorded in the hospital electronic health record (EHR). Although this data collection is neither standardized nor nationally mandated, several leading hospital systems have adopted similar procedures.

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.

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 CPT code for speech and language?

The CPT (Common Procedural Terminology ® American Medical Association) codes for evaluation and treatment of voice are the same, regardless of the patient’s medical diagnosis. SLPs typically use CPT codes 92524 (Behavioral and qualitative analysis of voice and resonance) and 92507 (Treatment of speech, language, voice, communication, and/or auditory processing disorder). A full list of CPT codes related to the evaluation and treatment of voice and communication disorders is available online.

Does voice therapy cover transgender patients?

Although access to transgender health services is improving, the level of coverage for voice therapy largely depends on the state and the patient’s health insurance plan. Seek legal counsel if you have questions about the impact of the ACA or state law on the reimbursement of voice therapy for transition-related care.

Does health insurance cover transgender people?

The federal Affordable Care Act (ACA) prohibits most types of health insurance—including private insurance and Medicaid—from categorically excluding services for people who are transgender.

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 ...