F64.1 vs F64.2
F64.1 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 F64.1
gender identity disorder in childhood (F64.2)
F64.1
Dual role transvestism
Billable
- Chapter 5
- Mental, Behavioral and Neurodevelopmental disorders
- Section
- F60-F69
Indexed under
- Transvestism, transvestitism (dual-role)
- Deviation › sexual › transvestism (in)
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