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ICD-10 Guide
ICD-10 CodesF52.9

F52.9

Billable

Unspecified sexual dysfunction not due to a substance or known physiological condition

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 F52.9 is a billable code used to indicate a diagnosis of unspecified sexual dysfunction not due to a substance or known physiological condition.

Key Diagnostic Point:

F52.9 refers to a category of sexual dysfunction that cannot be attributed to a specific substance use or a known physiological condition. This diagnosis encompasses a range of sexual issues that may manifest as a lack of sexual desire, difficulty in sexual arousal, or problems with orgasm. The condition is often multifactorial, influenced by psychological, emotional, and relational factors. It is important to note that this code is used when the clinician has ruled out other potential causes, including medical conditions such as diabetes or hormonal imbalances, as well as substance-induced dysfunctions. The diagnosis may be associated with psychological disorders, including anxiety, depression, or stress, which can significantly impact sexual function. Treatment often involves a multidisciplinary approach, including psychotherapy, counseling, and sometimes pharmacotherapy, depending on the underlying issues identified during the assessment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between psychological and physiological causes of dysfunction
  • Need for comprehensive patient history and assessment
  • Potential overlap with other sexual dysfunction codes
  • Variability in patient presentation and symptoms

Audit Risk Factors

  • Inadequate documentation of patient history
  • Failure to rule out physiological causes
  • Misuse of unspecified codes leading to denials
  • Inconsistent coding practices across providers

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed patient history, including psychological evaluations and treatment plans.

Common Clinical Scenarios

Patients presenting with anxiety or depression affecting sexual function.

Billing Considerations

Consideration of comorbid mental health disorders and their impact on sexual health.

Urology

Documentation Requirements

Assessment of any underlying urological conditions and their relation to sexual dysfunction.

Common Clinical Scenarios

Men presenting with erectile dysfunction without clear physiological causes.

Billing Considerations

Need for collaboration with mental health professionals for comprehensive care.

Coding Guidelines

Inclusion Criteria

Use F52.9 When
  • According to ICD
  • 10 guidelines, F52
  • 9 should be used when sexual dysfunction is not attributable to a substance or known physiological condition
  • Coders must ensure that all other potential causes have been ruled out and that the documentation supports the diagnosis

Exclusion Criteria

Do NOT use F52.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

90834CPT Code

Psychotherapy, 45 minutes

Clinical Scenario

Used for patients undergoing therapy for sexual dysfunction.

Documentation Requirements

Document the patient's progress and treatment goals.

Specialty Considerations

Psychiatrists should focus on the psychological aspects of sexual dysfunction.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of sexual dysfunctions, improving the ability to capture the nuances of these conditions. F52.9 provides a necessary option for cases where the cause is not clearly defined, but it requires careful documentation to avoid misinterpretation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sexual dysfunctions, improving the ability to capture the nuances of these conditions. F52.9 provides a necessary option for cases where the cause is not clearly defined, but it requires careful documentation to avoid misinterpretation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of sexual dysfunctions, improving the ability to capture the nuances of these conditions. F52.9 provides a necessary option for cases where the cause is not clearly defined, but it requires careful documentation to avoid misinterpretation.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What should be documented to support the use of F52.9?

Documentation should include a thorough patient history, assessment of psychological factors, and any evaluations performed to rule out physiological causes.