2025 ICD-10-CM code F65
Effective Date: N/A Mental, Behavioral and Neurodevelopmental disorders 6 Feed
Paraphilias
Medical necessity for treatment of paraphilic disorders is established by the presence of significant distress, impairment in functioning, or risk of harm to self or others due to the paraphilia.The documentation should clearly demonstrate how the individual's condition negatively impacts their life and requires intervention.
Clinicians diagnosing paraphilic disorders should assess the patient’s history, the intensity and duration of the paraphilia, and the level of distress or impairment caused.It is crucial to determine if the paraphilia poses a risk of harm to the patient or others.Treatment often involves psychotherapy, medication, or a combination of both, aiming to manage urges, reduce distress, and prevent harmful behaviors.
In simple words: Paraphilias involve sexual interests that are different from what most people consider normal.A person with a paraphilia experiences strong sexual urges or fantasies related to things that don't usually arouse others sexually.These interests can cause problems in their life and may even be harmful to themselves or others.If these interests cause significant distress or impairment, it is considered a paraphilic disorder.
Paraphilias are characterized by recurrent, intense sexual urges, fantasies, or behaviors involving unusual objects, activities, or situations not typically considered sexually arousing.These urges or behaviors must persist for at least six months and cause significant distress or impairment in social, occupational, or other important areas of functioning.The diagnosis of a paraphilic disorder also requires that the behavior involves harm or risk of harm to others or causes impairment in various life areas.
Example 1: A 30-year-old male experiences recurrent, intense sexual urges and fantasies involving non-consenting individuals. He has engaged in voyeuristic behaviors, causing distress and impacting his social life. This meets criteria for a paraphilic disorder – Voyeuristic Disorder., A 25-year-old female experiences significant distress due to her persistent sexual arousal from being bound or humiliated.She engages in these activities with consenting partners but feels ashamed and unable to form healthy relationships. This qualifies as a paraphilic disorder – Sexual Masochism Disorder., A 40-year-old male collects women's shoes and experiences sexual arousal from touching and smelling them.While he hasn't acted on these urges with non-consenting individuals, he experiences significant distress and impairment in his daily life due to his preoccupation with the shoes. This would be classified as a paraphilic disorder – Fetishistic Disorder.
Documentation should include a detailed history of the patient's sexual urges, fantasies, and behaviors, including onset, frequency, intensity, and duration.Any associated distress, impairment, or harm to self or others should be documented.The presence of any comorbid mental health conditions should also be noted.If the patient has engaged in illegal activities related to their paraphilia, this must be documented as well.
** It is important to approach the topic of paraphilias with sensitivity and without judgment.Individuals with paraphilic disorders may experience shame and guilt, and creating a safe and supportive environment is crucial for effective treatment.Furthermore, it's important to note that having a paraphilia doesn't automatically make someone a criminal, and many individuals with paraphilias never act on their urges in ways that harm others.
- Specialties:Psychiatry, Psychology, Sexology
- Place of Service:Outpatient Hospital, Inpatient Hospital, Psychiatric Facility-Partial Hospitalization, Community Mental Health Center, Psychiatric Residential Treatment Center, Non-residential Substance Abuse Treatment Facility