Wiki Transgender patients

[Brenda1973]

Please help. I have not had time to read up on outpatient coding of transgender. I came across this encounter today and since the patient identifies as a male, my system is red flagging the diagnosis. How do I over ride this?

HPI Pt is 27 yo FtM transgender patient at 11 weeks gestation presenting with UTI symptoms.

Diagnoses and all orders for this visit:
Acute cystitis without hematuria
Normal pregnancy, first trimester

 

[csperoni]

From my anecdotal experience, >10 years ago it was very difficult to even try to explain to the insurance company why you would be doing a gynecologic procedure or have a gynecologic dx on a male patient. You could call, write appeal letters, write more appeal letters, and still not receive payment. Currently, it is not so complicated. In fact, Medicare has instructed to use modifier -KX for exactly this situation. Most commercial carriers will reverse a denial on the first appeal letter if they do not acknowledge -KX for this situation. The use of 2ndary dx F64.0 and/or Z87.890 can also be helpful.
https://www.aapc.com/blog/36829-identify-transgender-coding-mishaps/
https://www.acog.org/practice-manag...n-coding-for-the-transgender-process-services
https://www.cms.gov/About-CMS/Agenc...gender-Population-in-the-Medicare-Program.pdf

 

[rachellzamora@gmail.com]

Please help. I have not had time to read up on outpatient coding of transgender. I came across this encounter today and since the patient identifies as a male, my system is red flagging the diagnosis. How do I over ride this?

HPI Pt is 27 yo FtM transgender patient at 11 weeks gestation presenting with UTI symptoms.

Diagnoses and all orders for this visit:
Acute cystitis without hematuria
Normal pregnancy, first trimester

Hello, I do transgender billing and I would say to bill it out as whatever gender their insurance has them under. I have to over ride my system a lot of the times when I get this error and have not had any issues when the insurance get it .

 

[amyjph]

Most EMRs now have a "birth sex" and an "identifies as" gender or other separated fields for this now too. So what goes on the claim would be one, but what is used to address or communicate with the patient would be their preferred. Or as stated above, there are modifiers for just this issue.