What ICD-10 Code is for Other Sexual Disorders?

Understanding F66: The ICD-10 Code for Other Sexual Disorders

The worldwide coding system for medical conditions, known as the International Classification of Diseases (ICD), was adopted in North America in 1898 and has been modified and updated numerous times since. To acknowledge its 10th major revision, this coding system is now known as the ICD-10 and remains valid throughout the United States. 

Ailments with the ICD-10 classification of F66 are termed “other sexual disorders.” Several psychological and behavioral disorders associated with sexual orientation and sexual development have this distinction.

What Sexual Disorders Does the ICD-10 Code F66 Include?

Nearly all general sexual disorders have a unique ICD-10 classification. There are multiple ICD-10 codes for sexual disorders, including R37 for sexual dysfunction and Z72.5 for high-risk sexual behavior. The ICD-10 code F66 applies to five separate sexual disorders, classified as “other sexual disorders.” These conditions are grouped due to their connections to sexual development and orientation, behavior, and psychology. These include sexual maturation disorder, egodystonic sexual orientation, sexual relationship disorder, other psychosexual development disorders, and psychosexual development disorder (unspecified).

F66.0: Sexual Maturation Disorder

Sexual maturation disorder often manifests in early childhood or adolescence. It is characterized by anxiety or depression arising from confusion about sexual orientation or gender identity. Although it is most common among adolescents who have always been unsure of their sexual orientation, sexual maturation disorder can also impact people with formerly stable sexual orientations.

While present in the World Health Organization’s (WHO) ICD-10 listing, the code F66.0 is not included in the 11th edition of the International Classification of Diseases, also known as the ICD-11. In 2014, in light of independent studies and reviews, the WHO determined there was insufficient justification for this category and thus it would be removed from the ICD-11 listing.

F66.1: Egodystonic Sexual Orientation

Egodystonic sexual orientation, listed as ICD-10 code F66.1, is characterized by having a sexual orientation that is at odds with one’s perceived self-image. This egodystonic mental health disorder causes anxiety and a need to change one’s sexual orientation to suit their self-image or outside expectations. People with egodystonic sexual orientation sometimes seek treatment to change their sexual orientation due to related behavioral and psychological disorders. Similar to ICD code F66.0, the 11th edition of the ICD does not include code F66.1.

F66.2: Sexual Relationship Disorder

Sexual relationship disorder, characterized as ICD-10 code F66.2, occurs when a person’s sexual orientation is disruptive or detrimental to their primary relationship. This condition can also apply to the individual’s gender identity. Much like codes F66.0 and F66.1, F66.2 for sexual relationship disorder has been removed from the ICD-11. However, this code is still used for billing purposes, mortality tracking, and more throughout the United States.

F66.8: Other Psychosexual Development Disorders

F66.8, the code used to describe “other psychosexual development disorders,” applies to psychosexual development disorders that don’t meet the criteria for F66.0, F66.1, or F66.2 but cause mental health issues due to gender identity, sexual preferences, sexual development, or sexual behaviors. Like some of the codes mentioned above, F66.8 is not listed in the ICD-11.

F66.9: Psychosexual Development Disorder – Unspecified

Unspecified psychosexual development disorder applies to any psychological and behavioral sexual conditions that don’t meet the criteria for other F66 codes. If a provider uses this code, they are not required to specify the exact nature of the ailment diagnosed, and the F66.9 code offers no indication of how to treat the condition.

How ICD-10 Codes Are Used

Healthcare providers use ICD-10 codes to classify and code diagnoses and services to process insurance claims accurately. In addition, having a universal standard for classifying different ailments allows researchers to share and study data more effectively. ICD codes were initially created to track mortality statistics. According to the Centers for Disease Control (CDC), the ICD-10 promotes global comparability in data collection, presentation, and processing.

National and International ICD Codes: Is There a Difference?

Issued by the WHO, ICD-10 codes serve as an international standard for disease classification. However, each country reserves the right to use both standard and modified ICD-10 codes to suit their research, classification, billing needs, and national mortality statistics. Using modified ICD-10 codes requires review and approval by the WHO.

ICD-10 Codes and the National Center for Health Statistics

The National Center for Health Statistics (NCHS) is a branch of the CDC and the Department of Health and Human Services (HHS). The NCHS uses ICD-10 codes to track mortality rates and causes of death via death certificates. To better suit its purposes and to make a clear distinction between internationally accepted ICD-10 codes, the NCHS uses the ICD-10-CM classification system, with CM indicating clinical modification.

ICD-10 Codes and the Centers for Medicare and Medicaid Services

To assign codes for hospitalization and other medical procedures, the Centers for Medicare and Medicaid Services (CMS) uses the ICD-10-PCS classification system. PCS stands for procedure coding system. On October 1, 2015, the CDC mandated the ICD-10-PCS for all providers, facilities, and other entities covered by the Health Insurance Portability and Accountability Act (HIPAA).

Why ICD Codes Are Important

ICD codes are important because they provide a common language that researchers, physicians, and others involved in healthcare can use worldwide to enter, share, and study data. According to the WHO, the ICD classification system is currently used in one version or another by all member States. 

The ICD Supports More Lucrative Reimbursement Models for the Treatment of Complex Issues

For healthcare providers and facilities, using the ICD-10 coding system opens the door to more lucrative compensation models for diseases requiring complex treatment. For instance, using ICD-10 code F66 allows the provider to bill specifically for psychological and behavioral disorders associated with sexual development and orientation.

The ICD Offers Universal Access to the Most Current Disease Classifications

Among the main objectives of the ICD-10 and all other versions of this classification system is permitting the analysis of common health conditions and systemic records worldwide. The ICD also aims to support and enhance the global collection and analysis of morbidity and mortality data via included diagnostic information to aid research in causes of death and the best means for preventing them.

Support Greater Accuracy in Diagnostic Coding and Improved Data Quality

A universal system for disease classification improves data quality across all participating WHO members. Countries that use the ICD-10 and ICD-11 coding systems have a lower likelihood of sharing misinformation or misinterpreting health data. This accuracy is due to the system’s straightforward numerical classifications and the availability of translations in more than 43 languages.

Access to Increased Data for Tracking Healthcare Services, Use, and Outcomes

As per WHO reporting requirements, many communicable illnesses are tracked nationally and globally. Using the ICD-10 and its subsequent version, the ICD-11, allows for improved public health monitoring and surveillance, helping researchers understand outbreaks, epidemics, and pandemics.

What Is a Deprecated ICD-10 Code?

When transitioning from the ICD-9 to the ICD-10 system, the CMS issued a list of inactive, non-billable codes. These are known as deprecated codes, and they refer to health issues no longer recognized or newly classed with other diseases by the WHO. When the ICD-11 is fully adopted in the United States, the absence of F66 codes in the unmodified ICD-11 will likely render the related “other sexual disorders” non-billable.

Are ICD-10 Codes for Other Sexual Disorders Currently Invalid?

The ICD-11 was introduced on January 1, 2022, and all F66 codes for other sexual disorders are notably absent. While already adopted by more than 60 countries, this revised classification system is still being introduced in the United States as of 2023. The required changes for full adoption are expected to take several years and include revised data standards for electronic health records due to the longer character lengths of the ICD-11’s clustered code structure. In the United States, this transition will require dual-coded data sets, translation software, and crosswalk mapping files, among other things. 

In the meantime, medical billers, providers, and healthcare facilities throughout the United States will continue using ICD-10 codes, including F66 codes for other sexual disorders. These codes are also still actively used by the CMC, CDC, and NCHS in their modified versions.

Why Were F66 Codes for Other Sexual Disorders Left Out of the ICD-11?

The ailments coded under F66 in the ICD-10 are no longer recognized as treatable conditions in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM), thus impacting the ICD-11. This is also true of similar medical references used by other WHO member countries. The diagnosis and treatment of the “other sexual disorders” listed under the F66 classification is a contentious one that is subject to fast-changing perceptions, human rights standards, and all relevant policies and laws throughout the world.

To further understand the classification needs of these conditions, the WHO commissioned The Working Group to research these disorders, including their prevalence, treatment, and other factors. Following its investigation, The Working Group recommended coding changes based on clinical practice and research. The Working Group also recommended a distinction between conditions relevant to clinical psychopathology and conditions that merely reflect individual or private behavior. While The Working Group studied all mental and behavioral disorders about gender identity and sexuality referenced in the ICD-10, this recommendation was specifically applied to the conditions classed under ICD-10 code F66.

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