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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