F52.5
F52.5: Vaginismus not due to a substance or known physiological condition
Billable / specific codeICD-10-CM
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.
Check F52.5 with the rest of the claim: free scrubberExcludes2: 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
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change 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 one applies depends on your Medicare contractor.
- 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
Alphabetic index entries that lead here
- 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
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under F52
- 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