FY2027
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Excludes1 pair

F64.0 vs F64.2

F64.0 and F64.2 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.

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
  • Disorder › gender-identity or -role › of adolescence or adulthood
  • 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
  • Identity disorder › psychosexual
  • Disorder › gender incongruence › of childhood

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