ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 F64.1

Billable / Specific

Dual role transvestism

F64
Block
0
Synonyms
262
LCDs
12
Payer Policies
65
Linked CPTs

About ICD-10-CM F64.1

ICD-10-CM code F64.1 represents Dual role transvestism. This is a billable/specific code in the Mental, Behavioral, and Neurodevelopmental chapter (block F64). The 2026 edition of ICD-10-CM F64.1 became effective on October 1, 2025.

Type 1 Excludes

Pure excludes, these codes can never be coded together with F64.1. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • gender identity disorder in childhood (F64.2)

Type 2 Excludes

Not included here, the excluded code is not part of F64.1, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.

  • fetishistic transvestism (F65.1)

Use Additional Code

When coding F64.1, also report these additional codes when applicable.

  • code to identify sex reassignment status (Z87.890)

Medicare LCD Coverage for F64.1

Local Coverage Determinations (LCDs) from CMS MACs that list F64.1 as a covered diagnosis.

262 LCDs

Showing top 10 of 262 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Psychiatric Inpatient Hospitalization
Article ID: 57052, Effective: 2026-03-26 00:00:00, 422 covered, 0 non-covered
CPT XX000 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90847 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT G0560 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT G0017 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90837 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90792 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90791 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90833 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90845 →
CMS LCD: Billing and Coding: Psychiatric Diagnostic Evaluation and Psychotherapy Services
Article ID: 57520, Effective: 2025-01-01 00:00:00, 582 covered, 1 non-covered
CPT 90840 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing F64.1.

12 policies

1 Aetna

Endometrial Ablation - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0091

2 Cigna

Gender Dysphoria Treatment - (0266)
Policy ID: MM_0266
Nucleic Acid Pathogen Testing - (0530)
Policy ID: MM_0530

5 Medicare

Billing and Coding: Sex Reassignment Services for Sexual Identity Dysphoria
Policy ID: ART-53793
Billing and Coding: Psychiatry and Psychology Services
Policy ID: ART-56937
Billing and Coding: Psychiatric Inpatient Hospitalization
Policy ID: ART-57052
Billing and Coding: Psychiatric Partial Hospitalization Programs
Policy ID: ART-57053
Billing and Coding: Psychiatric Codes
Policy ID: ART-57130

CPT Codes Commonly Billed with F64.1

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

65 linkages
  • J3145 CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone CMS LCD
  • 84403 CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone CMS LCD
  • 84410 CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone CMS LCD
  • J1072 CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone CMS LCD
  • 11980 CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone CMS LCD
  • J1071 CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone CMS LCD
  • J3121 CMS LCD: Billing and Coding: Treatment of Males with Low Testosterone CMS LCD
  • 15820 CMS LCD: Billing and Coding: Sex Reassignment Services for Sexual Identity Dysphoria CMS LCD
  • 56625 CMS LCD: Billing and Coding: Sex Reassignment Services for Sexual Identity Dysphoria CMS LCD
  • 21209 CMS LCD: Billing and Coding: Sex Reassignment Services for Sexual Identity Dysphoria CMS LCD

Convert F64.1 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
F64.1 30285 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 F64.1, Billing FAQ

Is ICD-10 code F64.1 billable? +

Yes, F64.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What codes are Type 1 Excludes for F64.1? +

Type 1 Excludes (never code together with F64.1): gender identity disorder in childhood (F64.2)

What codes are Type 2 Excludes for F64.1? +

Type 2 Excludes (may be coded together when both conditions exist): fetishistic transvestism (F65.1)

What CPT codes are commonly billed with F64.1? +

Procedures frequently paired with F64.1 include: J3145, 84403, 84410, J1072, 11980.

What ICD-9 codes does F64.1 map to? +

Per CMS GEMs, F64.1 maps to ICD-9 codes: 30285. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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