FY2027
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Excludes1 pair

F64.1 vs F64.2

F64.1 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 F64.1
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
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