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ICD-10 Guide
ICD-10 CodesF64.2

F64.2

Billable

Gender identity disorder of childhood

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

Code Description

ICD-10 F64.2 is a billable code used to indicate a diagnosis of gender identity disorder of childhood.

Key Diagnostic Point:

Gender identity disorder of childhood, classified under ICD-10 code F64.2, is characterized by a strong and persistent identification with a gender different from one's assigned sex at birth. This condition typically manifests in early childhood, often before the age of 10, and may include behaviors such as a strong preference for cross-gender roles in play, a rejection of toys and activities traditionally associated with one's assigned gender, and a desire to be treated as the opposite gender. Children with this disorder may express significant distress regarding their assigned gender and may exhibit maladaptive behaviors, such as social withdrawal or anxiety, stemming from their gender dysphoria. The diagnosis requires a comprehensive evaluation by a qualified mental health professional, who must consider the child's developmental stage and the cultural context of gender identity. Treatment may involve psychological support, family therapy, and, in some cases, medical interventions as the child matures. It is crucial for healthcare providers to approach this condition with sensitivity and understanding, recognizing the potential for stigma and discrimination that these children may face.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and symptoms among children
  • Need for comprehensive psychological evaluation
  • Cultural considerations in gender identity
  • Potential overlap with other mental health disorders

Audit Risk Factors

  • Inadequate documentation of symptoms and duration
  • Failure to differentiate from other mental health conditions
  • Lack of evidence for persistent gender identity issues
  • Insufficient clinical rationale for treatment

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed history of gender identity expression, family dynamics, and any co-occurring mental health issues.

Common Clinical Scenarios

Assessment of a child presenting with gender nonconformity and parental concerns about gender identity.

Billing Considerations

Consideration of developmental milestones and cultural factors influencing gender identity.

Psychiatry

Documentation Requirements

Comprehensive psychological evaluation, including assessment of co-morbid conditions and psychosocial factors.

Common Clinical Scenarios

Therapeutic interventions for children experiencing distress related to gender identity.

Billing Considerations

Sensitivity to the child's emotional state and the potential impact of societal stigma.

Coding Guidelines

Inclusion Criteria

Use F64.2 When
  • According to ICD
  • 10 guidelines, F64
  • 2 should be used when the child's gender identity is incongruent with their assigned sex and causes significant distress or impairment

Exclusion Criteria

Do NOT use F64.2 When
  • Exclusion criteria include conditions where gender identity issues are secondary to other mental health disorders

Related ICD-10 Codes

Related CPT Codes

90834CPT Code

Psychotherapy, 45 minutes with patient

Clinical Scenario

Used for therapy sessions addressing gender identity issues.

Documentation Requirements

Document the focus of therapy on gender identity and any co-occurring issues.

Specialty Considerations

Pediatric and psychiatric specialties should ensure sensitivity in documentation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of gender identity disorders, improving the ability to capture the nuances of these conditions and facilitating better patient care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of gender identity disorders, improving the ability to capture the nuances of these conditions and facilitating better patient care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of gender identity disorders, improving the ability to capture the nuances of these conditions and facilitating better patient care.

Resources

Clinical References

  • •
    American Psychiatric Association - Gender Dysphoria

Coding & Billing References

  • •
    American Psychiatric Association - Gender Dysphoria

Frequently Asked Questions

What is the difference between F64.2 and F64.0?

F64.2 refers specifically to gender identity disorder of childhood, while F64.0 pertains to transsexualism, which is typically diagnosed in adolescents and adults.