Billing and Coding: Sex Reassignment Services for Sexual Identity Dysphoria
National · Effective Oct 1, 2026
1 active Medicare policy lists 15769, and 23 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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National · Effective Oct 1, 2026
23 policies from 8 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 15769 |
|---|---|---|
| Back Pain - Invasive Procedures | Mar 13, 2024 | Covered |
| Hypertrophic Scars and Keloids | Jun 22, 2023 | Covered |
| Skin and Soft Tissue Substitutes | Feb 9, 2024 | Covered |
| Trigeminal Neuralgia: Treatments | Feb 15, 2024 | Covered |
| Xerostomia: Selected Treatments | May 8, 2023 | Covered |
| Policy |
|---|
| Effective |
|---|
| Status of 15769 |
|---|
| Cigna Commercial Other Services Code List | Mar 7, 2026 | Prior auth required |
|---|---|---|
| Cigna Comprehensive Code List | Mar 7, 2026 | Prior auth required |
| Injectable Fillers for Head and Neck Conditions | Jun 15, 2026 | Covered |
| Orthognathic Surgery | Oct 15, 2025 | Not covered |
| Scar Revision | Jun 15, 2026 | Covered |
| Policy | Effective | Status of 15769 |
|---|---|---|
| Adipose-derived Stem Cell Enrichment in Autologous Fat Grafting to the Breast | Feb 1, 2026 | Covered |
| Cosmetic and Reconstructive Procedures | Sep 1, 2026 | Covered |
| Gender Affirming Interventions for Gender Dysphoria | Apr 1, 2026 | Covered |
| Reconstructive Breast Surgery/Mastopexy, and Management of Breast Implants | Dec 1, 2025 | Covered |
| Policy | Effective | Status of 15769 |
|---|---|---|
| Adipose-Derived Stem Cells in Autologous Fat Grafting to the Breast | Oct 1, 2026 | Covered |
| Reconstructive Breast Surgery | May 15, 2026 | Covered |
| Policy | Effective | Status of 15769 |
|---|---|---|
| Adipose-Derived Stem Cells in Autologous Fat Grafting to the Breast | Oct 1, 2026 | Covered |
| Reconstructive Breast Surgery | May 15, 2026 | Covered |
| Policy | Effective | Status of 15769 |
|---|---|---|
| Adipose-Derived Stem Cells in Autologous Fat Grafting to the Breast | Oct 1, 2026 | Covered |
| Reconstructive Breast Surgery | May 15, 2026 | Covered |
| Policy | Effective | Status of 15769 |
|---|---|---|
| Adipose-Derived Stem Cells in Autologous Fat Grafting to the Breast | Oct 1, 2026 | Covered |
| Reconstructive Breast Surgery | May 15, 2026 | Covered |
| Policy | Effective | Status of 15769 |
|---|---|---|
| Cosmetic and Reconstructive Procedures | Jun 1, 2026 | Covered |