2025 ICD-10-CM code F64.2
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Mental, Behavioral, and Neurodevelopmental Disorders - Gender identity disorders Mental, Behavioral and Neurodevelopmental disorders (F01-F99) Feed
Gender identity disorder of childhood, characterized by persistent distress regarding assigned sex and a desire to be the opposite sex, manifesting before puberty.
Not applicable to ICD-10 codes.
Medical necessity is established through a comprehensive evaluation demonstrating significant distress and impairment in the child's daily life due to gender dysphoria.The diagnosis must meet the criteria for F64.2, including the duration of symptoms and the absence of puberty.
Diagnosis and treatment are typically the responsibility of a psychiatrist, psychologist, or other qualified mental health professional.Depending on the complexity of the case and the needs of the child and family, a multidisciplinary approach may be warranted involving pediatricians, endocrinologists, and social workers.
In simple words: This code describes when a child feels very unhappy about being assigned a particular sex at birth and strongly identifies as the opposite sex. This feeling must have been going on for at least six months and the child must not yet have started puberty.It is more than just a child acting in ways that are not typical for their assigned gender.
F64.2, Gender identity disorder of childhood, is an ICD-10-CM code that describes a condition typically emerging in early childhood, always before puberty.It's characterized by persistent and intense distress about the child's assigned sex at birth, coupled with a strong desire to be, or insistence that they are, of the opposite sex. This includes persistent preoccupation with the dress and activities of the opposite sex and a rejection of their own sex.Diagnosis requires a significant disruption of normal gender identity; simple tomboyishness in girls or girlish behavior in boys is insufficient.The condition must be present for at least six months, and the child must not yet have reached puberty.The disorder is often associated with significant emotional distress and a higher risk of psychiatric comorbidities, including anxiety and depression.
Example 1: A 6-year-old girl consistently expresses discomfort with her female anatomy and insists she is a boy, wanting to dress and play as boys do.This has persisted for over six months., An 8-year-old boy exhibits distress over his male anatomy, prefers wearing girls' clothing, and engages in activities typically associated with girls. This behavior significantly impacts his social interactions and emotional well-being., A 7-year-old child assigned female at birth consistently identifies as male, showing intense distress when referred to using feminine pronouns and experiencing significant social difficulties due to this.
* Detailed history of the child's gender identity and expression, including onset and duration.* Documentation of the child's distress and impact on their social and emotional functioning.* Assessment of any associated mental health conditions (anxiety, depression).* Information regarding the child's developmental stage and family dynamics.* Evidence of attempts to manage the condition (e.g., psychotherapy).
** This code should only be used for children who have not yet reached puberty.For adolescents and adults, use F64.0 (Transsexualism) or other appropriate codes.
- Revenue Code: Revenue codes will vary depending on the services provided (e.g., psychotherapy, counseling).
- RVU: RVUs are not directly associated with ICD-10 codes.Reimbursement is determined by the procedures and services provided, which would use CPT or HCPCS codes with associated RVUs.
- Global Days : Not applicable to ICD-10 codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule : Not applicable to ICD-10 codes. Reimbursement is determined by the services rendered and billed with CPT or HCPCS codes.
- Specialties:Child Psychiatry, Pediatric Endocrinology, Psychology
- Place of Service:Office, Outpatient Hospital, Psychiatric Facility-Partial Hospitalization, Inpatient Hospital