Chapter 4
Section 16.1
Intersex Surgery
Issue Date: August 26, 1985
Copyright: CPT
only © 2006 American Medical Association (or such other date of
publication of CPT).
All Rights Reserved.
Revision: C-1, March 10, 2017
1.0 CPT
PROCEDURE CODE RANGE
55970 - 55980
2.0 DESCRIPTION
Intersex involves an individual who shows intermingling,
in varying degrees, of the characteristics of each sex, including
physical form, reproductive organs, and sexual behavior.
3.0 POLICY
Surgery performed to correct ambiguous genitalia
which has been documented to be present at birth is a covered benefit.
4.0 EXCLUSION
All services and supplies directly and indirectly
related to surgical treatment (i.e., sex gender change),
except when performed to correct ambiguous genitalia which
is documented to have been present
at birth (CPT procedure codes 55970 and 55980).
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