ICD-10 Coding for Gender Dysphoria(F64.0, F64.2)
Complete ICD-10-CM coding and documentation guide for Gender Dysphoria. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Gender Dysphoria
F64Primary Range
Gender identity disorders
This range includes all codes related to gender identity disorders, including gender dysphoria.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| F64.0 | Transsexualism | Use for adolescents and adults with persistent gender incongruence and distress lasting at least 6 months. |
|
| F64.2 | Gender identity disorder of childhood | Use for children under 18 with gender dysphoria symptoms. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for gender dysphoria
Essential facts and insights about Gender Dysphoria
Primary ICD-10-CM Codes for gender dysphoria
Decision Criteria
clinical Criteria
- Persistent gender incongruence and distress for at least 6 months
Applicable To
- Persistent gender incongruence in adolescents and adults
Excludes
- Body dysmorphic disorder
- Transvestic disorder
Clinical Validation Requirements
- Marked incongruence between experienced gender and assigned sex
- Distress impairing social or occupational functioning
- 12+ months of hormone therapy or social transition
Code-Specific Risks
- Using this code without documented evidence of distress and duration
Coding Notes
- Ensure documentation includes DSM-5-TR criteria and excludes other mental health disorders.
F64.2 - Gender identity disorder of childhood
Use for children under 18 with gender dysphoria symptoms.
Applicable To
- Gender dysphoria in children under 18
Excludes
- Gender dysphoria in adolescents and adults
Clinical Validation Requirements
- Verbalized desire to be another gender
- Strong rejection of gender-typical toys or activities
Coding Notes
Ensure age-appropriate documentation and exclusion of other developmental disorders.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Personal history of sex reassignment
Z87.890Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Gender Dysphoria to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F64.0.
Impact
Clinical: Inaccurate diagnosis and treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Use structured templates for documentation.
Impact
Reimbursement: May lead to denied claims due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Reduces accuracy of clinical data.
Mitigation Strategy
Review documentation to ensure the most specific code is used based on age and clinical details.
Impact
Failure to document DSM-5-TR criteria can lead to audit issues.
Mitigation Strategy
Use standardized templates and checklists.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Gender Dysphoria, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Gender Dysphoria
Use these documentation templates to ensure complete and accurate documentation for Gender Dysphoria. These templates include all required elements for proper coding and billing.
Mental Health Assessment
Specialty: PsychiatryRequired Elements
- Duration of incongruence
- Functional impacts
- Diagnostic confirmation
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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