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  • Coding for Breast Augmentation and Removal for Gender Affirming Surgery . . .
    The American Medical Association (AMA) recently updated their guidance for the correct Current Procedural Terminology (CPT®) codes to use when filing claims for breast removal and breast augmentation as part of gender reassignment surgeries
  • Gender Dysphoria and Gender Reassignment Surgery
    UnitedHealthcare Medicare Advantage Policies use Current Procedural Terminology (CPT®), Centers for Medicare and Medicaid Services (CMS), or other coding guidelines
  • Gender Affirmation Surgery - healthplan. org
    Coding Note: In female to male gender afirming surgery CPT code 19318 should be used to report a reduction and or feminizing mammoplasty Use of CPT code 19303 is inappropriate as it is intended for use in breast cancer treatment
  • 7. 01. 557 Gender Transition Affirmation Surgery and Related Services
    This policy describes the procedures that are covered as part of gender transition affirmation surgery and the criteria that are required for coverage Note: The Introduction section is for your general knowledge and is not to be taken as policy coverage criteria
  • Gender Affirming Surgical Interventions - Providence Health Plan
    Service Medicare Guidelines Medicare Coverage Criteria: “MA organizations may create publicly accessible internal coverage criteria when coverage criteria are not fully established in applicable Medicare statutes, regulations, NCDs or LCDs ” (§ 422 101(b)(6) – see Policy Guidelines below)
  • Wiki - mastectomy for gender transition | Medical Billing and Coding . . .
    Good morning Looking for a pathology cpt code for a mastectomy for gender transition from female to male Struggling between 88305 and 88307 I welcome any insights
  • Gender Affirming Services Corporate Medical Policy
    See coding tables below for procedures (Attachment I), and diagnosis (Attachment II) which are eligible per this medical policy Procedures listed below may be eligible when medical necessity and documentation requirements outlined within this policy are met
  • WPATH HPP Surgery for Handouts
    CPT codes listed in this presentation are the most frequently utilized As surgeries can differ depending on clinical situation and surgeon approach and as surgeries evolve, other CPT codes may be submitted by individual providers




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