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ICD-10 Guide
ICD-10 CodesF65.1

F65.1

Billable

Transvestic fetishism

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

Code Description

ICD-10 F65.1 is a billable code used to indicate a diagnosis of transvestic fetishism.

Key Diagnostic Point:

Transvestic fetishism is characterized by the recurrent and intense sexual arousal from cross-dressing, which may involve wearing clothing typically associated with the opposite gender. This condition is classified under paraphilic disorders in the ICD-10, indicating that it can lead to significant distress or impairment in social, occupational, or other important areas of functioning. Individuals with transvestic fetishism may engage in cross-dressing as a means of sexual expression, and this behavior can be associated with a variety of psychological factors, including impulse control issues and maladaptive behaviors. It is important to differentiate transvestic fetishism from gender dysphoria, as the former does not necessarily involve a desire to change one's gender identity. Treatment may involve psychotherapy, particularly cognitive-behavioral therapy, to address any underlying issues and to help individuals manage their behaviors in a socially acceptable manner. Understanding the nuances of this condition is crucial for accurate diagnosis and coding, as it intersects with discussions around personality disorders and gender identity.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other paraphilic disorders
  • Potential overlap with gender identity issues
  • Variability in presentation and severity
  • Need for comprehensive patient history

Audit Risk Factors

  • Inadequate documentation of the patient's history and symptoms
  • Failure to note associated distress or impairment
  • Misclassification with other paraphilic disorders
  • Lack of clarity in treatment plans

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed patient history, including onset and duration of symptoms, impact on functioning, and any co-occurring mental health conditions.

Common Clinical Scenarios

Assessment of patients presenting with distress related to cross-dressing behaviors, evaluation of impulse control issues.

Billing Considerations

Consideration of cultural factors and the patient's perspective on their behavior is essential for accurate diagnosis.

Psychology

Documentation Requirements

Comprehensive psychological evaluations, including standardized assessments of sexual functioning and identity.

Common Clinical Scenarios

Therapeutic interventions focusing on maladaptive behaviors and coping strategies.

Billing Considerations

Therapists should be aware of the stigma associated with transvestic fetishism and approach treatment with sensitivity.

Coding Guidelines

Inclusion Criteria

Use F65.1 When
  • According to ICD
  • 10 guidelines, transvestic fetishism is coded when the behavior causes significant distress or impairment
  • It is important to document the specific nature of the fetishistic behavior and its impact on the patient's life

Exclusion Criteria

Do NOT use F65.1 When
  • Exclusion criteria include cases where the behavior is not distressing or impairing

Related ICD-10 Codes

Related CPT Codes

90834CPT Code

Psychotherapy, 45 minutes with patient

Clinical Scenario

Used for therapy sessions addressing issues related to transvestic fetishism.

Documentation Requirements

Document the patient's presenting problems, treatment goals, and progress.

Specialty Considerations

Psychiatrists and psychologists should ensure that therapy is tailored to the individual's needs.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of paraphilic disorders, including transvestic fetishism, which helps in better understanding and treatment of these conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of paraphilic disorders, including transvestic fetishism, which helps in better understanding and treatment of these conditions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of paraphilic disorders, including transvestic fetishism, which helps in better understanding and treatment of these conditions.

Resources

Clinical References

  • •
    American Psychiatric Association - Diagnostic and Statistical Manual of Mental Disorders

Coding & Billing References

  • •
    American Psychiatric Association - Diagnostic and Statistical Manual of Mental Disorders

Frequently Asked Questions

What is the difference between transvestic fetishism and gender dysphoria?

Transvestic fetishism involves sexual arousal from cross-dressing, while gender dysphoria is characterized by a strong desire to be of the opposite gender. The two conditions can coexist but are distinct in their diagnostic criteria.