F64.0 ICD-10-CM Code: Transsexualism
HCC Buddy Code Card
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FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Disorders of adult personality and behavior (F60-F69)
F64.0
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceTranssexualism
A condition where an individual has a persistent desire to live and be accepted as a member of the opposite sex, often involving medical transition.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Gender dysphoria in adolescents and adults
- Gender identity disorder in adolescence and adulthood
- Gender incongruence in adolescents and adults
- Transgender
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for F64.0 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for F64.0 in this effective period.
Excludes 1
Official- gender identity disorder of childhood (F64.2)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for F64.0 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for F64.0 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for F64.0 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is F64.0 an HCC code?
No. F64.0 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- F64.0
- Description
- Transsexualism
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
F64.0 is the ICD-10-CM diagnosis code for transsexualism. A condition where an individual has a persistent desire to live and be accepted as a member of the opposite sex, often involving medical transition. F64.0 sits in the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99), within the section covering disorders of adult personality and behavior (f60-f69).
F64.0 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Document the duration of gender dysphoria and the individual's stated gender identity.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for F64.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the duration of gender dysphoria and the individual's stated gender identity
- •Note any associated medical or surgical interventions being pursued or completed
Excludes 1, Do NOT code together
- gender identity disorder of childhood (F64.2)