ICD-10 Coding for Hormone Therapy(F64.0, Z79.890)
Complete ICD-10-CM coding and documentation guide for Hormone Therapy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hormone Therapy
F64-F64.9Primary Range
Gender identity disorders
Primary range for gender dysphoria and related hormone therapy.
Hypofunction and other disorders of the pituitary gland
Relevant for hormone therapy due to pituitary disorders.
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 patients diagnosed with gender dysphoria undergoing hormone therapy. |
|
| Z79.890 | Hormone replacement therapy | Use for patients on long-term hormone therapy, such as for gender transition or menopause. |
|
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 hormone therapy
Essential facts and insights about Hormone Therapy
Primary ICD-10-CM Codes for hormone therapy
Decision Criteria
clinical Criteria
- Patient diagnosed with gender dysphoria and receiving hormone therapy.
Applicable To
- Gender dysphoria
Excludes
- Non-binary gender identity
Clinical Validation Requirements
- Formal diagnosis of gender dysphoria
- Mental health evaluation documentation
Code-Specific Risks
- Denial if not supported by mental health documentation
Coding Notes
- Ensure mental health documentation is included to support F64.0.
Z79.890 - Hormone replacement therapy
Use for patients on long-term hormone therapy, such as for gender transition or menopause.
Applicable To
- Long-term hormone therapy
Excludes
- Short-term hormone therapy
Clinical Validation Requirements
- Documentation of hormone therapy exceeding 12 months
- Specific hormone levels within target range
Coding Notes
Ensure therapy duration and hormone levels are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hormone Therapy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F64.0.
Impact
Clinical: May lead to inappropriate treatment, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Ensure mental health evaluations are documented
Impact
Reimbursement: Claims may be denied if incorrect duration is coded., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on therapy duration.
Mitigation Strategy
Use Z79.3 for short-term hormone therapy.
Impact
Inadequate documentation of therapy duration and mental health evaluations
Mitigation Strategy
Regular audits of patient records to ensure compliance
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 Hormone Therapy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hormone Therapy
Use these documentation templates to ensure complete and accurate documentation for Hormone Therapy. These templates include all required elements for proper coding and billing.
Gender-Affirming Hormone Therapy
Specialty: EndocrinologyRequired Elements
- Patient gender identity
- Hormone therapy details
- Mental health evaluation
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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