Brucellosis by Pat Conrad MD

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In anticipation of the Diane Sawyer, uh, sit down with former Olympian Bruce Jenner, the topic is sure to come up in your practice. As the transgender continues to multiply, further complicated by the impending ICD-10, here is the latest info to assist you in treating the LGBTWTFE community.

From icd9data.com:
“ICD-9-CM 302.85 converts approximately to: 2015 ICD-10-CM F64.1 Gender identity disorder in adolescence and adulthood … or …. 2015 ICD-10-CM Z87.890 Personal history of sex reassignment.”
From Tufts Health Care:

“Gender reassignment surgery is part of a treatment plan for gender identity dysphoria (World Professional Association for Transgender Health [WPATH], 2014). When the (coverage) guidelines are met, Tufts Health Plan may authorize one or more of the following covered surgeries, up to the Member’s benefit limit:

Male-to-Female Procedures

– Penectomy
– Orchiectomy
– Vaginoplasty
– Clitoroplasty
– Labiaplasty
– Vulvoplasty
– Mammaplasty (breast augmentation)
– Prostatectomy
– Urethroplasty

Tufts Health Plan does not cover the reversal of any of the procedures listed above. Tufts Health Plan does not cover the surgical procedures listed below performed for the purpose of transgender surgery because they are considered cosmetic for all Members :

– Facial bone reduction
– Blepharoplasty
– Breast augmentation or reconstruction to alter breast contour
– Rhinoplasty
– Rhytidectomy
– Osteoplasty
– Genioplasty
– Forehead augmentation
– Penile prosthetic
– Reduction thyroid chondroplasty
– Body contouring procedures, i.e., abdominoplasty, suction-assisted lipoplasty, liposuction or lipofilling

According to the American Academy of Professional Coders:

“Claims for some transgender or hermaphrodite services may be inadvertently denied due to sex-related edits unless these services are billed properly. The National Uniform Billing Committee (NUBC) approved condition code 45 Ambiguous gender category to identify these unique claims and to allow proper processing.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected]