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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