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The procedure described by CPT® Code 55970 refers to intersex surgery specifically aimed at transitioning from male to female genitalia. This surgical intervention involves the use of plastic surgery techniques to reconstruct male genital structures into female anatomical features. The process is designed to align the physical characteristics of the individual with their gender identity, providing a means for those undergoing gender transition to achieve a body that reflects their gender identity. The surgery may involve various techniques, including the removal of male genitalia and the creation of female genital structures, which can include the formation of a neovagina and the construction of external female genitalia. This procedure is a critical component of gender-affirming care for individuals seeking to transition from male to female, addressing both physical and psychological aspects of gender dysphoria.
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The indications for performing intersex surgery, specifically male to female transition surgery, include the following:
The procedure for male to female intersex surgery involves several critical steps, each designed to facilitate the transformation of male genitalia into female genitalia. The following outlines the procedural steps:
Post-procedure care for patients undergoing male to female intersex surgery is critical for recovery and includes several key considerations. Patients are typically monitored in a recovery area until they are stable and can be safely discharged. Pain management is an essential aspect of post-operative care, and patients may be prescribed analgesics to manage discomfort. Additionally, patients are advised on wound care to prevent infection and promote healing. Follow-up appointments are necessary to assess healing, address any complications, and provide ongoing support for the patient's transition process. Patients may also receive guidance on sexual health and function as they adjust to their new anatomy.
| Short Descr | SEX TRANSFORMATION M TO F | Medium Descr | INTERSEX SURG MALE FEMALE | Long Descr | Intersex surgery; male to female | Status Code | Carriers Price the Code | Global Days | YYY - Carrier Determines Whether Global Concept Applies | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 118 - Other OR therapeutic procedures, male genital |
| 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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