Health Information Technologies and Processes

Male Patient Identifies as Female- Coding Issue

  • 1.  Male Patient Identifies as Female- Coding Issue

    Posted 12-18-2019 10:51
    I would like to know how other facilities are dealing with issues such as male patients identifies himself as female but the diagnosis is a male diagnosis and now the all the systems in the computer are putting hard stops for us to code and bill this account.

    I would like to know if any of you have a policy in place for these types of issues. Also, have you been able to change the gender just for billing purposes?

    I appreciate all you help in this matter!!

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    Mayra Allemond
    Him Director
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  • 2.  RE: Male Patient Identifies as Female- Coding Issue

    Posted 12-18-2019 10:57

    Hi, we register the patient based on gender at birth and preferred gender. When it comes to billing it is tough but we have to change the sex to get the bill dropped and then change it back. We have what are called special indicators in our EMR that give patients like this a specific alert for all users. It is definitely not an easy process because our EMR does not allow for any of these special cases. It is a lot of manual work. Hope this helps.


    Thanks,

    Karla

     






  • 3.  RE: Male Patient Identifies as Female- Coding Issue

    Posted 12-18-2019 12:31
    Karla,

    This is the same thing I was thinking, however; my concern with doing this is that the insurance company has this particular patient as a "female" in their records and his birth gender is "male". I am worried that once we send the bill out it will show the incorrect gender which could cause the claim to not get paid.
    The only other thing I saw was something about using condition code 45. Is this something you are familiar with?

    thank you!

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    Mayra Allemond
    Him Director
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  • 4.  RE: Male Patient Identifies as Female- Coding Issue

    Posted 12-18-2019 13:16

    I am not familiar with condition code 45 but I do understand from the coding area that sometimes we get rejections, while other times we do not. It depends on the insurance carrier. It is a crap shoot at this time.

     

    Karla