F64.0 vs F64.2
F64.0 and F64.2 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on F64.0
gender identity disorder of childhood (F64.2)
F64.0
Transsexualism
Billable
- Chapter 5
- Mental, Behavioral and Neurodevelopmental disorders
- Section
- F60-F69
Use when the record says
- Gender dysphoria in adolescents and adults
- Gender identity disorder in adolescence and adulthood
- Gender incongruence in adolescents and adults
- Transgender
Indexed under
- Transgender
- Transsexualism
- Disorder › gender incongruence › in adolescents and adults (of)
- Disorder › gender-identity or -role › of adolescence or adulthood (of)
- Dysphoria › gender › in › adolescence and adulthood
F64.2
Gender identity disorder of childhood
Billable
- Chapter 5
- Mental, Behavioral and Neurodevelopmental disorders
- Section
- F60-F69
Use when the record says
- Gender dysphoria in children
- Gender incongruence of childhood
Indexed under
- Psychosexual identity disorder of childhood
- Crisis › psychosexual identity
- Identity disorder › gender role (child)
- Identity disorder › psychosexual (child)
- Disorder › gender incongruence › of childhood (of)
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027