Wiki Gender Affirming procedural coding education

[tloeb]

Hi All,
I have been tasked with coding for gender affirming procedures. Does know of any educational material or presentations? I currently code for OB/GYN and Gyn Onc so some of these procedures are easy - hysterectomies etc, however, the plastic procedures are much more intimidating without the coding experience. I have searched on line for education but am coming up short. I do have material from WPATH that is helpful but looking for anything else that may exist.

Thank you!

 

[antoniamay]

I would look up your payers resources most plans if you google Aetna Gender Affirming Guidelines or BCBS it will give you resources on what they allow and don't allow. I think that different payers set up different rules in this case I would defer to those sites to guide you in some ways.

 

[simplyvocalart@gmail.com]

Honestly, I only saw like 2 codes in CPT for it in OB\GYN.

 

[TThivierge]

Hello Tloeb,​

Here is data from Medicare - Billing and Coding: Gender Reassignment Services for Gender Dysphoria A53793​

Reference :NCD - Gender Dysphoria and Gender Reassignment Surgery (140.9)​

This are some CPT codes related to transgender surgery of penis, vagina, face and breast reconstruction​

Possible Dx code block F64,N64, Z98.52, F52, N53,N48​

Here are some of the main CPT codes ....​

Remove penis CPT 54125 - and CPT 55970 male to female, CPT 19325 Breast implants for humans​

Remove vagina surgery 57292 ,57281, 57335 and female to male CPT 55980 but review site to get just of all surgery and care involved. I learned that some transgender males do not get prostate removed thus still need prostate check every year.​

​

Listed below are medical procedures GD humans may use......​

• Breast reconstruction (e.g., mastectomy) - removal of breast
• Hysterectomy - removal of uterus
• Salpingo-oophorectomy - removal of fallopian tubes and ovaries
• Vaginectomy - removal of vagina
• Vulvectomy - removal of vulva
• Metoidioplasty - creation of micro-penis, using clitoris
• Phalloplasty - creation of penis, with or without urethra
• Urethroplasty - creation of urethra within the penis
• Scrotoplasty - creation of scrotum
• Testicular prostheses - implantation of artificial testes
• Removal of penis
• Liposuction: removal of fat
• Rhinoplasty: reshaping of nose
• Rhytidectomy: face lift
• Blepharoplasty: removal of redundant skin of upper and/or lower eyelids and protruding periorbital fat
• Hair removal/ hair transplantation
• Facial feminizing (e.g., facial bone reduction)
• Chin augmentation: reshaping or enhancing the size of the chin
• Collagen injections
• Lip reduction/enhancement: decreasing/enlarging lip size
• Cricothyroid approximation: voice modification that raises the vocal pitch by simulating contractions of the cricothyroid muscle with sutures

Well hope I helped you ​

Lady T​