The Comprehensive Guide to Gender Reassignment Surgery: Risks and
Things that you need to Know about gender reassignment surgery
(PDF) Gender reassignment surgery: An overview
Guide On Gender Reassignment Surgery
Male To Female Gender Reassignment Surgery
Brief Overview on Gender Reassignment Surgery Female to Male
COMMENTS
Billing and Coding: Gender Reassignment Services for Gender Dysphoria
The difference between cross-sex hormone therapy and gender reassignment surgery is that the surgery is considered an irreversible physical intervention. Gender reassignment surgical procedures are not without risk for complications; therefore, individuals should undergo an extensive evaluation to explore psychological, family, and social ...
Clear Up Misconceptions About Transgender Coding
ICD-10-CM Coding Tied to Gender Transition. 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. For a person to be diagnosed with gender dysphoria ...
2025 ICD-10-PCS Procedure Code 0W4M070
ICD-10-PCS 0W4M070 is a specific/billable code that can be used to indicate a procedure. ICD-10-PCS 0W4M070 is intended for males as it is clinically and virtually impossible to be applicable to a female. Code History. 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-PCS)
Coding for the Transgender Process Services
Answer. 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.".
2025 ICD-10-CM Diagnosis Code Z87.890
Z87.890 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2025 edition of ICD-10-CM Z87.890 became effective on October 1, 2024. This is the American ICD-10-CM version of Z87.890 - other international versions of ICD-10 Z87.890 may differ. Z codes represent reasons for encounters. A ...
ICD-10-PCS Procedure Code 0W4N071
Explanation: Used for gender reassignment surgery and corrective procedures in individuals with congenital anomalies. ... The 2025 ICD-10-PCS codes are to be used for discharges occurring from October 1, 2024 through September 30, 2025. Each ICD-10-PCS code has a structure of seven alphanumeric characters and contains no decimals. The first ...
PDF Surgical Treatment of Gender Dysphoria
member who has undergone or is planning to undergo gender reassignment surgery, include but are not limited to: Facial hair removal ... Treatments for the purpose of sex reassignment are subject to the member's contract benefits. Some contracts have no benefits. ... ICD-10 PCS 0W4M070 Creation of Vagina in Male Perineum with Autologous ...
From Registration to Claims Billing, Overcome Gender Identity ...
Gender reassignment surgery is intended to be a permanent change between an individual's gender identity and physical appearance — it is not easily reversible. ... Litriana (Lee) Shimano, CPC, CMDP, CCP, PCS, AHIMA Approved ICD-10-CM/PCS Trainer, is an educator with a 30-year background in the healthcare industry. She has had management ...
Taking a Closer Look at the June ICD-10 Coding Challenge
F64.1 Gender identity disorder in adolescence and adulthood. Root Operation. 0W4M070. BLOG RESPONSE: The recent news coverage of a former Olympic gold medalist and media figure who transitioned from male to female provides the opportunity to understand how sex reassignment surgery is captured in ICD-10-PCS.
PDF GENDER REASSIGNMENT SURGERY MODEL NCD
Gender Reassignment Surgery Model NCD | 3 physical sex and their gender identity. While the DSM-V and ICD-10 classify it as a mental health diagnosis, the WHOs draft of ICD-11 removes this diagnosis from the mental health section and provides a new name for the condition (gender incongruence) and classifies it in conditions related to sexual ...
PDF Clinical Review Criteria Related to Gender Reassignment Surgery
There is no hormonal therapy requirement for mastectomy only. 5. Member has lived as their reassigned gender full time for 12 months or more. 6. Member's medical and mental health providers document that there are no contraindications for the planned surgery and agree with the plan. 7.
Gender Affirmation Surgery: A Primer on Imaging Correlates for the
The medical classification of gender incongruence has gone through significant change in the past decades ().In the most recent revision of the International Classification of Diseases (ICD-11), gender incongruence is defined as "a marked and persistent incongruence between an individual's experienced gender and the assigned sex" [].This definitional phrasing is distinct because of its ...
PDF Gender Reassignment Surgery
Description of Procedure or Service. Gender reassignment surgery (also known as genital reconstruction surgery, sex affirmation surgery, or sex-change operation) is a term for the surgical procedures by which a person's physical appearance and function of their existing sexual characteristics are altered to resemble that of the other sex.
Gender Dysphoria and Gender Reassignment Procedures
ICD-10-CM Diagnosis Codes. Once the above criteria are met, codes from F64.0-F64.9 may be used to describe the type of gender dysphoria diagnosed. F64.0 - Gender dysphoria in adolescents and adults. F64.1 - Dual role transvestitism (not enough gender dysphoria to show interest in gender reassignment surgery)
Gender Dysphoria and Gender Reassignment Surgery
Use this page to view details for NCD - Gender Dysphoria and Gender Reassignment Surgery (140.9). ... (LCD) policy or Article ID; or a CPT/HCPCS procedure/billing code or an ICD-10-CM diagnosis code. Try entering any of this type of information provided in your denial letter. 3) Contact your MAC. 4) Visit Medicare.gov or call 1-800-Medicare.
Gender Affirmation Surgery: A Primer on Imaging Correlates for ...
ICD-8a = ICD, revision 8a; ICD-9-CM = ICD, 9th edition, Clinical Modification; ICD-10-CM, ICD, 10th revision, Clinical Modification; ICD-10-PCS = ICD, 10th revision, Procedure Codes; TBD = to be determined. aTerms denoting gender incongruence are presented in order (from left to right) from earliest to most recently used term.
Male-to-Female Gender-Affirming Surgery: 20-Year Review of Technique
Transsexualism (ICD-10) or Gender Dysphoria (GD) (DSM-5) ... Massuda R, Henriques AA, et al. WHOQOL-100 before and after sex reassignment surgery in brazilian male-to-female transsexual individuals. J Sex Med. (2016) 13:988-93. 10.1016/j.jsxm.2016.03.370 [Google Scholar] 22. Murad MH, Elamin MB, Garcia MZ, Mullan RJ, Murad A, Erwin PJ, et al ...
PDF Medical Policy Transgender Services
Gender Reassignment Surgery (GRS) may be MEDICALLY NECESSARY when ALL of the following candidate criteria are met and supporting provider documentation is provided: The candidate is at least 18 years of age, AND. The candidate has been diagnosed with gender dysphoria (ICD-9 Code 302.85 gender identity disorder), including meeting ALL of the ...
0W4M0J0
0W4M0J0. 0W4M0J0 is a valid billable ICD-10 procedure code for Creation of Vagina in Male Perineum with Synthetic Substitute, Open Approach. It is found in the 2025 version of the ICD-10 Procedure Coding System (PCS) and can be used in all HIPAA-covered transactions from Oct 01, 2024 - Sep 30, 2025. When using code 0W4M0J0 in processing claims ...
2025 ICD-10-CM Diagnosis Code F64.9
The 2025 edition of ICD-10-CM F64.9 became effective on October 1, 2024. This is the American ICD-10-CM version of F64.9 - other international versions of ICD-10 F64.9 may differ. A disorder characterized by a strong and persistent cross-gender identification (such as stating a desire to be the other sex or frequently passing as the other sex ...
IMAGES
COMMENTS
The difference between cross-sex hormone therapy and gender reassignment surgery is that the surgery is considered an irreversible physical intervention. Gender reassignment surgical procedures are not without risk for complications; therefore, individuals should undergo an extensive evaluation to explore psychological, family, and social ...
ICD-10-CM Coding Tied to Gender Transition. 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. For a person to be diagnosed with gender dysphoria ...
ICD-10-PCS 0W4M070 is a specific/billable code that can be used to indicate a procedure. ICD-10-PCS 0W4M070 is intended for males as it is clinically and virtually impossible to be applicable to a female. Code History. 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-PCS)
Answer. 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.".
Z87.890 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2025 edition of ICD-10-CM Z87.890 became effective on October 1, 2024. This is the American ICD-10-CM version of Z87.890 - other international versions of ICD-10 Z87.890 may differ. Z codes represent reasons for encounters. A ...
Explanation: Used for gender reassignment surgery and corrective procedures in individuals with congenital anomalies. ... The 2025 ICD-10-PCS codes are to be used for discharges occurring from October 1, 2024 through September 30, 2025. Each ICD-10-PCS code has a structure of seven alphanumeric characters and contains no decimals. The first ...
member who has undergone or is planning to undergo gender reassignment surgery, include but are not limited to: Facial hair removal ... Treatments for the purpose of sex reassignment are subject to the member's contract benefits. Some contracts have no benefits. ... ICD-10 PCS 0W4M070 Creation of Vagina in Male Perineum with Autologous ...
Gender reassignment surgery is intended to be a permanent change between an individual's gender identity and physical appearance — it is not easily reversible. ... Litriana (Lee) Shimano, CPC, CMDP, CCP, PCS, AHIMA Approved ICD-10-CM/PCS Trainer, is an educator with a 30-year background in the healthcare industry. She has had management ...
F64.1 Gender identity disorder in adolescence and adulthood. Root Operation. 0W4M070. BLOG RESPONSE: The recent news coverage of a former Olympic gold medalist and media figure who transitioned from male to female provides the opportunity to understand how sex reassignment surgery is captured in ICD-10-PCS.
Gender Reassignment Surgery Model NCD | 3 physical sex and their gender identity. While the DSM-V and ICD-10 classify it as a mental health diagnosis, the WHOs draft of ICD-11 removes this diagnosis from the mental health section and provides a new name for the condition (gender incongruence) and classifies it in conditions related to sexual ...
There is no hormonal therapy requirement for mastectomy only. 5. Member has lived as their reassigned gender full time for 12 months or more. 6. Member's medical and mental health providers document that there are no contraindications for the planned surgery and agree with the plan. 7.
The medical classification of gender incongruence has gone through significant change in the past decades ().In the most recent revision of the International Classification of Diseases (ICD-11), gender incongruence is defined as "a marked and persistent incongruence between an individual's experienced gender and the assigned sex" [].This definitional phrasing is distinct because of its ...
Description of Procedure or Service. Gender reassignment surgery (also known as genital reconstruction surgery, sex affirmation surgery, or sex-change operation) is a term for the surgical procedures by which a person's physical appearance and function of their existing sexual characteristics are altered to resemble that of the other sex.
ICD-10-CM Diagnosis Codes. Once the above criteria are met, codes from F64.0-F64.9 may be used to describe the type of gender dysphoria diagnosed. F64.0 - Gender dysphoria in adolescents and adults. F64.1 - Dual role transvestitism (not enough gender dysphoria to show interest in gender reassignment surgery)
Use this page to view details for NCD - Gender Dysphoria and Gender Reassignment Surgery (140.9). ... (LCD) policy or Article ID; or a CPT/HCPCS procedure/billing code or an ICD-10-CM diagnosis code. Try entering any of this type of information provided in your denial letter. 3) Contact your MAC. 4) Visit Medicare.gov or call 1-800-Medicare.
ICD-8a = ICD, revision 8a; ICD-9-CM = ICD, 9th edition, Clinical Modification; ICD-10-CM, ICD, 10th revision, Clinical Modification; ICD-10-PCS = ICD, 10th revision, Procedure Codes; TBD = to be determined. aTerms denoting gender incongruence are presented in order (from left to right) from earliest to most recently used term.
Transsexualism (ICD-10) or Gender Dysphoria (GD) (DSM-5) ... Massuda R, Henriques AA, et al. WHOQOL-100 before and after sex reassignment surgery in brazilian male-to-female transsexual individuals. J Sex Med. (2016) 13:988-93. 10.1016/j.jsxm.2016.03.370 [Google Scholar] 22. Murad MH, Elamin MB, Garcia MZ, Mullan RJ, Murad A, Erwin PJ, et al ...
Gender Reassignment Surgery (GRS) may be MEDICALLY NECESSARY when ALL of the following candidate criteria are met and supporting provider documentation is provided: The candidate is at least 18 years of age, AND. The candidate has been diagnosed with gender dysphoria (ICD-9 Code 302.85 gender identity disorder), including meeting ALL of the ...
0W4M0J0. 0W4M0J0 is a valid billable ICD-10 procedure code for Creation of Vagina in Male Perineum with Synthetic Substitute, Open Approach. It is found in the 2025 version of the ICD-10 Procedure Coding System (PCS) and can be used in all HIPAA-covered transactions from Oct 01, 2024 - Sep 30, 2025. When using code 0W4M0J0 in processing claims ...
The 2025 edition of ICD-10-CM F64.9 became effective on October 1, 2024. This is the American ICD-10-CM version of F64.9 - other international versions of ICD-10 F64.9 may differ. A disorder characterized by a strong and persistent cross-gender identification (such as stating a desire to be the other sex or frequently passing as the other sex ...