F52.5 — Vaginismus not due to a substance or known physiological condition
F52.5 is a billable, specific ICD-10-CM code for vaginismus not due to a substance or known physiological condition. It is valid for submission on a claim.
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- vaginismus (due to a known physiological condition) (N94.2)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Psychogenic vaginismus
Other codes that can never be billed with F52.5
These codes carry an Excludes1 note pointing at F52.5. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading F52.5 alone.
- N94.2Vaginismus
Risk adjustment
F52.5 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
F52.5 is named in 13 Medicare coverage policies — 7 listing it as supporting medical necessity, and 6 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52434Health and Behavior Assessment/Intervention – Medical Policy Articlenot covered
- A57701Billing and Coding: Trigger Point Injections (TPI)not covered
- A59480Billing and Coding: Trigger Point Injections (TPI)not covered
- A59487Billing and Coding: Trigger Point Injections (TPI)not covered
How F52.5 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to F52.5.
- Vaginismus›functional
- Vaginismus›nonorganic
- Vaginismus›psychogenic
- Dysfunction›sexual›vaginismus(nonorganic) (psychogenic)
- Spasm, spastic, spasticity›vagina›psychogenic
- Dysfunction›psychosexual›with›vaginismus
- Dysfunction›sexual›female›psychogenic›vaginismus
- Dysfunction›sexual›female›vaginismus›psychogenic
Related codes at this level
Codes that share F52. If F52.5 is not quite right, the correct code is usually one of these.
- F52.0Hypoactive sexual desire disorder
- F52.1Sexual aversion disorder
- F52.2Sexual arousal disorders
- F52.3Orgasmic disorder
- F52.4Premature ejaculation
- F52.6Dyspareunia not due to a substance or known physiological condition
- F52.8Other sexual dysfunction not due to a substance or known physiological condition
- F52.9Unspecified sexual dysfunction not due to a substance or known physiological condition
Questions about F52.5
- Is F52.5 a billable ICD-10-CM code?
- Yes. F52.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F52.5 sit in the tabular list?
- Mental, Behavioral and Neurodevelopmental disorders (F01-F99), in the block Behavioral syndromes associated with physiological disturbances and physical factors (F50-F59).