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Not Sure How to Feel About This

Started by Amadeus, December 14, 2014, 01:08:54 AM

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Amadeus

I go to a clinic that is part of the Morehouse Medical Association in Atlanta.  They're great.  They believe in treating their patients with respect and dignity, no matter their gender, gender identity, race, religion, sexuality, etc.  I'm about to find out how well they do with transition, as they're sort of my only shot.  [Kinda sucks, but then again, Georgia.]

Anyway, MMA uses Webview to connect with their patients, upload lab results, that sort of thing.  I love it.  It's great!  My physician and I are in touch and we can discuss how I'm so not going to take any cholesterol meds.  I can look at my bloodwork, obsess over my TSH, and generally have better control over my healthcare.

So, I logged in tonight to view some labwork from about a week ago.  Everything looked fine.  I checked out the diagnoses tab.  I'm not sure how to feel about what was entered for my visit on 5 December.  The code is F64.2: Gender Identity Disorder in Children.  This concerns me.  Why?  I'M THIRTY-THREE YEARS OLD.  I'm not a child, haven't been for some time.  So, what the smeg?

There are two other diagnostic codes from two previous appointments: 302.6 00 [Gender Dysphoria] and F64.9 [also Gender Dysphoria].  I haven't seen any of their psychologists or psychiatrists, although I did ask my psychs to please work with Morehouse.  Do you think this particular code, F64.9, was added because of information shared by my outside psychologist?  Or do you think this was an oversight and I should report it for inaccuracy?
 
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adrian

It sounds like someone entered a wrong code when they weren't paying attention ;). I'd point it out to them, I think there will be a simple enough explanation.
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Ms Grace

I'd say it's an oversight, just let them know and they'll fix it.
Grace
----------------------------------------------
Transition 1.0 (Julie): HRT 1989-91
Self-denial: 1991-2013
Transition 2.0 (Grace): HRT June 24 2013
Full-time: March 24, 2014 :D
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LoriLorenz

Did you speak with your Psych about having GID as a kid? If you did, maybe it was shared (since you said work with them) and the extra code was added to add extra info that the other two codes don't include?
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Bimmer Guy

Quote from: Amadeus on December 14, 2014, 01:08:54 AM
I go to a clinic that is part of the Morehouse Medical Association in Atlanta.  They're great.  They believe in treating their patients with respect and dignity, no matter their gender, gender identity, race, religion, sexuality, etc.  I'm about to find out how well they do with transition, as they're sort of my only shot.  [Kinda sucks, but then again, Georgia.]

Anyway, MMA uses Webview to connect with their patients, upload lab results, that sort of thing.  I love it.  It's great!  My physician and I are in touch and we can discuss how I'm so not going to take any cholesterol meds.  I can look at my bloodwork, obsess over my TSH, and generally have better control over my healthcare.

So, I logged in tonight to view some labwork from about a week ago.  Everything looked fine.  I checked out the diagnoses tab.  I'm not sure how to feel about what was entered for my visit on 5 December.  The code is F64.2: Gender Identity Disorder in Children.  This concerns me.  Why?  I'M THIRTY-THREE YEARS OLD.  I'm not a child, haven't been for some time.  So, what the smeg?

There are two other diagnostic codes from two previous appointments: 302.6 00 [Gender Dysphoria] and F64.9 [also Gender Dysphoria].  I haven't seen any of their psychologists or psychiatrists, although I did ask my psychs to please work with Morehouse.  Do you think this particular code, F64.9, was added because of information shared by my outside psychologist?  Or do you think this was an oversight and I should report it for inaccuracy?

My guess is those codes are in there because you talked to them or other medical providers (whose records were transferred to them) about having gender dysphoria.  Not from your psych unless you gave them permission to speak to them.  It is what the Morehouse doctors keyed in.

With that said, those codes are not correct for you.

The DSM 5 changed the names/codes last year.  Looks like they are using a bit of the DSM IV TR and a bit of the DSM 5

Gender Identity in Children no longer exists (it is Gender Dysphoria in Children 302.6 (F64.2)).  More, importantly, you are above age 17, so it should be removed.

Gender Disorder, NOS (302.6) is a diagnosis that no longer exists.  It was used for someone who struggled with gender dysphoria, but who the medical provider did not see has having full blown "Gender Identity Disorder" (the person may be unsure if they are the opposite gender, they may be deciding if they are non binary, for example).  This was dropped as a diagnosis between the DSM IV TR and the currently used DSM 5

The active diagnosis you should have is Gender Dysphoria in Adolescents and Adults (302.85) (F64.1).  I would ask for them to remove the other two as being active diagnoses.

Hope this helps.

Top Surgery: 10/10/13 (Garramone)
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Bran

Knowing a thing about medical coding software-- they probably typed in "gender identity disorder" into a search function and clicked the first thing that came up.  It might not even have appeared as "gender identity disorder [in children]" when they made the selection.  Totally an inadvertent (and common, and embarassing) error.
***
Light is the left hand of darkness
and darkness the right hand of light.

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Amadeus

Quote from: Brett on December 14, 2014, 09:18:06 AM
My guess is those codes are in there because you talked to them or other medical providers (whose records were transferred to them) about having gender dysphoria.  Not from your psych unless you gave them permission to speak to them.  It is what the Morehouse doctors keyed in.

With that said, those codes are not correct for you.

The DSM 5 changed the names/codes last year.  Looks like they are using a bit of the DSM IV TR and a bit of the DSM 5

Gender Identity in Children no longer exists (it is Gender Dysphoria in Children 302.6 (F64.2)).  More, importantly, you are above age 17, so it should be removed.

Gender Disorder, NOS (302.6) is a diagnosis that no longer exists.  It was used for someone who struggled with gender dysphoria, but who the medical provider did not see has having full blown "Gender Identity Disorder" (the person may be unsure if they are the opposite gender, they may be deciding if they are non binary, for example).  This was dropped as a diagnosis between the DSM IV TR and the currently used DSM 5

The active diagnosis you should have is Gender Dysphoria in Adolescents and Adults (302.85) (F64.1).  I would ask for them to remove the other two as being active diagnoses.

Hope this helps.
Thanks Brett!  This makes sense.  I'll print out the diagnosis page and take it with me, see if I can get this fixed.

I did sign release forms with my psychologist and psychiatrist, so I'm sure there's been some discussion.  Part of the joys of going to Morehouse is that they will ask if your GP can confer with other in-house physicians about how best to treat you.  I have no problem with that.  Many brains make better decisions.  At least that's my hope.
 
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Greeneyedrebel

Amadeus,

I'm curious if having the GD diagnosis in the system is giving you any insurance issues? Or perhaps you are paying out-of-pocket?

My doc was able to avoid putting any GD codes down , and I'm thankful. This is Louisiana, and a GD code would send my insurance running for the hills. Thanks to having some really wonky hormone levels and a thyroid with a mind of its own....she coded for completely non-GD related DX's and my insurance is happily paying for everything. I also had SEVERE migraines for years, and the doc dug up a study touting the benefits of T for migraine relief when the migraines are caused by wonky hormone levels.
To be or not to be....that is the question
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Amadeus

Greeneyedrebel, I'm on Medicare, hence one of the main reasons I'm seeing Morehouse physicians.  Don't get me wrong, these are great doctors and nurses and such.  But it's very rare to find a reputable physician who accepts Medicare.  Since the ban was lifted in July, they will pay for GRS.  It's just finding someone who accepts it and will do a decent job that's a challenge.  I'm about to find out if Morehouse's plastic surgeon is any good at this sort of thing.  [My consult is on 27 December 2014].
 
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