F64.1

F64.1: Dual role transvestism

Billable / specific codeICD-10-CM

F64.1 is a billable, specific ICD-10-CM code for dual role transvestism. It is valid for submission on a claim.

Check F64.1 with the rest of the claim: free scrubber

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

gender identity disorder in childhood (F64.2)

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.

fetishistic transvestism (F65.1)

Use additional code

Add a secondary code to capture the detail described below.

code to identify sex reassignment status (Z87.890-)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

F64.1 is named in 11 Medicare coverage policies: 9 listing it as supporting medical necessity, and 2 listing it as NOT covered. Which one applies depends on your Medicare contractor.

A52434Health and Behavior Assessment/Intervention – Medical Policy Articlenot covered
A56865Billing and Coding: Psychiatric Inpatient Hospitalizationnot covered
A53793Billing and Coding: Sex Reassignment Services for Sexual Identity Dysphoria
A56937Billing and Coding: Psychiatry and Psychology Services