icd code for transgendered voice

The R49 series of codes describe voice and resonance disorders and may be used in conjunction with ICD-10-CM codes related to gender dysphoria (F64 series) for voice therapy that is part of transition-related care. There is also a code used to report a personal history of sex reassignment (Z87.890).

Full Answer

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.

How are transgender medical services diagnosed and coded?

Proper diagnosis and procedural coding of transgender medical services begins with understanding the spectrum of gender identity variations. 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 are the ICD-10 codes for voice and resonance disorders?

The R49 series of codes describe voice and resonance disorders and may be used in conjunction with ICD-10-CM codes related to gender dysphoria (F64 series) for voice therapy that is part of transition-related care. There is also a code used to report a personal history of sex reassignment (Z87.890).

What is the ICD 10 code for transsexualism?

Transsexualism. F64.0 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 F64.0 became effective on October 1, 2018. This is the American ICD-10-CM version of F64.0 - other international versions of ICD-10 F64.0 may differ.

Is there an ICD-10 code for transgender?

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. 890).”

Is transgender voice therapy covered by insurance?

Private Insurance Like Medicaid, very few state laws mention coverage for voice therapy for transgender or gender diverse people. However, many of the state laws prohibit insurers from denying or excluding medically necessary services related to the diagnosis of gender dysphoria.

What is the ICD-10 code for transgender male?

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 the ICD-10 code for transgender male to female?

Personal history of sex reassignment The 2022 edition of ICD-10-CM Z87. 890 became effective on October 1, 2021. This is the American ICD-10-CM version of Z87. 890 - other international versions of ICD-10 Z87.

How much does transgender voice therapy cost?

The Robbins Speech, Language and Hearing Center open_in_new offers individual and group voice therapy- including evaluation, therapy sessions, and follow up evaluations- for transgender individuals. Anyone can benefit from these services, which are $30 per individual session and $25 per group session.

Is FFS covered by insurance?

FFS is generally considered 'cosmetic' and not a medical necessity and, therefore, excluded from insurance coverage.

How do you code transgender?

ICD-10-CM Coding Tied to Gender Transition Use code Z87. 890 Personal history of sex reassignment for sex reassignment surgery (SRS) status.

What is the modifier for transgender?

modifier KXSummary: Use modifier KX (requirements specified in the medical policy have been met) and Condition Code 45 (Ambiguous Gender Category) on claims for services for transgender, ambiguous gender, or hermaphrodite patients.

What is diagnosis code f64 9?

9: Gender identity disorder, unspecified.

What is the gender dysphoria?

Gender dysphoria is a term that describes a sense of unease that a person may have because of a mismatch between their biological sex and their gender identity. This sense of unease or dissatisfaction may be so intense it can lead to depression and anxiety and have a harmful impact on daily life.

What is gender affirmation?

Gender-affirming care, as defined by the World Health Organization, encompasses a range of social, psychological, behavioral, and medical interventions “designed to support and affirm an individual's gender identity” when it conflicts with the gender they were assigned at birth.

How is gender dysphoria diagnosed?

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. ... DSM-5.

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.

What is the CPT code for SLPs?

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.

Is voice therapy necessary for gender transition?

Typically, voice therapy is considered medically necessary for certain diagnoses , such as vocal cord nodules or muscle tension dysphonia. Voice therapy related to gender transition may be covered if the client has a medical diagnosis of gender dysphoria. (Payers and state laws differ as to which medical professionals—usually physicians and mental health providers—are qualified to assign this diagnosis).

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.

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 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 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).

When did transgender surgery start?

Although gender dysphoria has been around throughout history, transgender surgery only began in the early 1900s. Here is a time line of its progress in the medical field: 1930 – Under the care of Magnus Hirschfeld, Lili Elbe became the first person to undergo transsexual surgery.

Federal and State Laws and Regulations

Laws related to gender identity are constantly evolving. Title VII of the 1964 Civil Rights Act, a federal regulation, prohibits discrimination in any federally funded program on the basis of race, color, sex, or national origin.

Payer Policies

SLPs should keep in mind that there is significant variability in coverage for services related to gender affirmation. Such services may be covered with the medical diagnosis of "gender dysphoria." According to The Report of the 2015 U.S.

Coding for Reimbursement

Each claim that is submitted to a payer for reimbursement of voice therapy should include both International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes to report the patient’s medical and treating diagnosis, and Current Procedural Terminology (CPT® American Medical Association) codes to report the services provided by the SLP..

Other Resources

Finding Insurance for Transgender-Related Healthcare, by the Human Rights Campaign.

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.