{"id":2597803,"date":"2026-05-01T16:55:02","date_gmt":"2026-05-01T20:55:02","guid":{"rendered":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/doctors-can-fraudulently-code-trans-child-genital-mutilation-to-bypass-bans-report\/"},"modified":"2026-05-01T17:01:42","modified_gmt":"2026-05-01T21:01:42","slug":"doctors-can-fraudulently-code-trans-child-genital-mutilation-to-bypass-bans-report","status":"publish","type":"post","link":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/doctors-can-fraudulently-code-trans-child-genital-mutilation-to-bypass-bans-report\/","title":{"rendered":"Report: Doctors Can Miscode Child Genital Mutilation To Skirt Bans"},"content":{"rendered":"<aside class=\"mashsb-container mashsb-main mashsb-stretched\"><div class=\"mashsb-box\"><div class=\"mashsb-count mash-medium\" style=\"&quot;\"><div class=\"counts mashsbcount\">20<\/div><span class=\"mashsb-sharetext\">SHARES<\/span><\/div><div class=\"mashsb-buttons\"><a class=\"mashicon-facebook mash-medium mash-nomargin mashsb-noshadow\" href=\"https:\/\/www.facebook.com\/sharer.php?u=https%3A%2F%2Fwww.conservativenewsdaily.net%2Fbreaking-news%2Fdoctors-can-fraudulently-code-trans-child-genital-mutilation-to-bypass-bans-report%2F\" target=\"_top\" rel=\"nofollow\"><span class=\"icon\"><\/span><span class=\"text\">Facebook<\/span><\/a><a class=\"mashicon-twitter mash-medium mash-nomargin mashsb-noshadow\" href=\"https:\/\/twitter.com\/intent\/tweet?text=&amp;url=https:\/\/www.conservativenewsdaily.net\/breaking-news\/?p=2597803&amp;via=ConservNewsDly\" target=\"_top\" rel=\"nofollow\"><span class=\"icon\"><\/span><span class=\"text\">Twitter<\/span><\/a><a class=\"mashicon-subscribe mash-medium mash-nomargin mashsb-noshadow\" href=\"#\" target=\"_top\" rel=\"nofollow\"><span class=\"icon\"><\/span><span class=\"text\">Subscribe<\/span><\/a><div class=\"onoffswitch2 mash-medium mashsb-noshadow\" style=\"display:none\"><\/div><\/div>\n            <\/div>\n                <div style=\"clear:both\"><\/div><\/aside>\n            <!-- Share buttons by mashshare.net - Version: 4.0.47--><p>The article claims that doctors may be using misleading or fraudulent ICD-10-CM diagnosis and related medical billing codes to conceal what it describes as \u201ctransgender\u201d procedures for children from insurers and regulators.It cites a report by the medical watchdog group Do No Harm, which argues that clinicians can substitute generic endocrine-related codes (such as those for various hormone or puberty-related conditions) in place of codes tied to gender identity, possibly allowing children to receive irreversible treatments while also enabling providers to get paid.<\/p>\n<p>The piece explains that ICD-10-CM codes are used for medical billing and reporting, and it alleges the coding rules are not being followed \u201cto the highest level of specificity\u201d when documentation supports or else. It describes the report\u2019s <a href=\"https:\/\/amzn.to\/3YuVZYV\" >methodology-comparing prescription fulfillment data<\/a> (e.g., testosterone) with nearby office visits, and flagging cases that occur shortly before\/after visits without the expected gender-identity-related code. It also points to surgical billing patterns (e.g., mastectomy codes paired with endocrine diagnoses) as additional indicators.<\/p>\n<p>Beyond coding practices, the article argues that certain pro-trans organizations have encouraged or publicly promoted these non-gender-identity coding approaches for reimbursement purposes, naming WPATH and others and citing past training materials and coding guides. It concludes by urging payors and regulators-especially in states restricting such care for minors-to monitor endocrine and other medical codes to prevent what the report characterizes as inaccurate or non-medically-supported reimbursement.  <\/p>\n<p class=\"readmore\">\n    <button onclick=\"showReadMore()\" id=\"readmorebtn\">Read more&#8230;<\/button>\n<\/p>\n<hr id=\"line\">\n<span id=\"more\"><\/p>\n<div>\n<p><em>Editor\u2019s note: This <a href=\"https:\/\/www.conservativenewsdaily.net\/breaking-news\/california-fights-to-screen-men-for-cervical-cancer\/\" title=\"California Fights To Screen Men For Cervical Cancer\">article discusses human reproductive anatomy<\/a>.<\/em><\/p>\n<p>Doctors are able to use fraudulent or misleading medical codes in order to hide \u201ctransgender\u201d procedures from insurance companies and regulators, allowing them to potentially bypass state bans on genital mutilation and chemical castration, according to a new report.<\/p>\n<p>The <a href=\"https:\/\/donoharmmedicine.org\/wp-content\/uploads\/Potential-Fraud-Skirt-Coding-Rules-GAC-Paper-4-8-26.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">report<\/a> from medical watchdog group Do No Harm shows how doctors are able to use medical codes claiming things like generic endocrine care as stand-ins for so<a href=\"https:\/\/www.conservativenewsdaily.net\/breaking-news\/john-daniel-davidson-we-need-to-stop-calling-ourselves-conservatives\/\" title=\"John Daniel Davidson: We Need To Stop Calling Ourselves Conservatives\">-called \u201cgender-affirming\u201d interventions<\/a> for children \u2014 both allowing the children to receive the irreversible drugs and procedures and ensuring doctors get paid for doing so. It also details how pro-mutilation groups like the World Professional Association for Transgender Health (WPATH) allegedly encourage doctors to do so.<\/p>\n<p>\u201cMedical diagnosis codes are being subverted by gender ideologues to avoid proper reporting, hide their activism from scrutiny, and enable potentially fraudulent billing practices. Groups like WPATH have publicly promoted the use of misleading diagnosis codes, and our report exposes how providers have financial incentives to do so,\u201d stated Kurt Miceli, chief medical officer at Do No Harm and author of the report. \u201cBy hiding transgender procedures behind codes meant for other conditions, providers are \u2014 at minimum \u2014 skirting guidelines and ethical standards. Our report highlights the need for greater regulatory oversight and medical review to ensure ICD-10 diagnosis codes are not being fraudulently misused.\u201d<\/p>\n<p>Health care providers use ICD-10-CM (<a href=\"https:\/\/www.cdc.gov\/nchs\/icd\/icd-10-cm\/index.html\" target=\"_blank\" rel=\"noreferrer noopener\">International Classification of Diseases<\/a>) diagnosis codes to designate diagnoses and injuries for purposes of medical billing and data reporting. These codes allow Centers for Disease Control and Prevention (CDC) personnel to see how widespread certain illnesses are across the country, for example.<\/p>\n<p>Medical professionals are supposed to \u201ccode to the highest level of specificity when supported by the medical record documentation,\u201d <a href=\"https:\/\/www.cms.gov\/files\/document\/fy-2025-icd-10-cm-coding-guidelines.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">according<\/a> to the ICD-10-CM Official Guidelines for Coding and Reporting.<\/p>\n<p>The fraudulent or misleading use of medical codes is something on the radar of the Department of Health and Human Services (HHS), as The Federalist <a href=\"https:\/\/thefederalist.com\/2025\/03\/13\/exclusive-linda-mcmahon-meets-with-detransitioners-to-discuss-schools-pushing-gender-transition\/\" target=\"_blank\" rel=\"noreferrer noopener\">reported<\/a>. But despite <a href=\"https:\/\/thefederalist.com\/2025\/12\/18\/hhs-moves-to-defund-hospitals-and-states-pushing-gender-transition-on-children\/\" target=\"_blank\" rel=\"noreferrer noopener\">an impending federal ban<\/a>, along with numerous state bans, on health care providers and insurance companies using Medicaid funding to cover interventions like opposite-sex hormones and unnecessary mastectomies for children, some doctors may still be able to get away with it.<\/p>\n<p>The report points to multiple pieces of evidence that doctors are using misleading or fraudulent coding in order to bypass protections that would prevent children from undergoing the interventions. Miceli uses a prescription fulfillment database for pharmacies as well as a database for medical claims that includes office visits. Then, with the National Provider Identifier (NPI), he attempts to establish a correlation between a prescription filled and an office visit, using the timeframe between the two data points to have \u201chigher confidence in the association.\u201d<\/p>\n<p>\u201cA prescription claim for testosterone in an adolescent female within 3 days of an office visit without an F64 ICD-10 diagnosis code for that visit would raise concerns of potential miscoding of the office visit claim,\u201d the report states, noting that some of the data can be skewed because even sex markers in medical claims \u201ccannot always be trusted\u201d because \u201cfemales may be coded as males and vice versa.\u201d F64 ICD-10 codes cover \u201cgender identity disorders.\u201d<\/p>\n<p>A surgical code coupled with an ICD-10 diagnosis code could also indicate cause for concern, the report states: \u201cAn otherwise healthy adolescent female, for instance, who has a CPT code for mastectomy and an ICD-10 diagnosis code for an endocrine disorder would arouse suspicion.\u201d<\/p>\n<p>The report identifies eight codes that may be the most likely to hide child \u201ctransition\u201d interventions from insurers and regulators, including hypopituitarism, other primary ovarian failure, testicular hypofunction, precocious puberty, other specified endocrine disorders, unspecified endocrine disorder, hormone replacement therapy, and hypertrophy of breast.<\/p>\n<p>Concern about doctors misusing the coding system to hide mutilation \u2014 and getting paid to do so \u2014 is not theoretical. Many major medical groups that advocate for and are otherwise involved in child mutilation have publicly voiced their intent to mislead.<\/p>\n<p>According to the report, 2021 training materials from WPATH \u201cendorsed the application of endocrine-related ICD-10 diagnosis codes for sex change treatments and insurance reimbursement.\u201d<\/p>\n<p>The Campaign for Southern Equality <a href=\"https:\/\/web.archive.org\/web\/20250328104449\/https:\/southernequality.org\/wp-content\/uploads\/2019\/03\/InsuranceCoding.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">published<\/a> a list of \u201cinsurance coding alternatives for trans healthcare,\u201d which the report notes encouraged \u201cthe use of these misleading codes to avoid scrutiny and obfuscate sex-denying medical interventions.\u201d<\/p>\n<p>The publication provided the following commentary:<\/p>\n<blockquote>\n<p>Some coverage is categorically excluded because they are viewed as cosmetic (i.e. breast augmentation, body contouring, facial feminization procedures) \u2014 generally speaking, these are hard to appeal and clearly delineate why they are medically necessary to meet the insurer\u2019s standards. Some \u201csubprocedures\u201d are also not covered, even if they main procedure is covered (i.e. double mastectomy is covered for transgender men, but not nipple reconstruction; phalloplasty may be covered, but the testicular implants are not, often citing cosmetic purposes) \u2014 when this occurs, the service is easier to appeal, because most of these procedures are available to cisgender people, and the case can be made that the \u201ccosmetic ruling\u201d is being applied to trans people for the sake of denying care (i.e. sex discrimination).<\/p>\n<\/blockquote>\n<p>The guide has apparently been removed from public view since March 2025, just after the Trump administration came into the White House.<\/p>\n<p>However, <a href=\"https:\/\/www.plannedparenthood.org\/planned-parenthood-southeastern-pennsylvania\/patients\/transgender-health-care\/gender-affirming-care-faq\" target=\"_blank\" rel=\"noreferrer noopener\">Planned Parenthood of Southeastern Pennsylvania<\/a> \u201cexplicitly states that it uses endocrine disorder codes \u2018in order to meet the needs of most insurance companies and patients\u2019 and only \u2018occasionally\u2019 uses gender identity disorder codes,\u201d the report states, while QueerDoc \u201calso notes on its website that \u2018some providers use the code <em>E34.9, Endocrine disorder, unspecified<\/em>.\u2019\u201d<\/p>\n<p>\u201cOrganizations such as WPATH, the Campaign for Southern Equality, Planned Parenthood, and QueerDoc have publicly promoted the use of non-F64 diagnosis codes in connection with so<a href=\"https:\/\/www.conservativenewsdaily.net\/breaking-news\/mtg-says-multiple-federal-agencies-investigating-swatting-attempts-against-her\/\" title=\"MTG Says Multiple Federal Agencies Investigating Swatting Attempts Against Her\">-called \u2018gender-affirming care<\/a>,\u2019\u201d the report states. \u201cPayors and regulators \u2014 particularly in states that restrict such interventions for minors \u2014 should remain vigilant for any misuse of endocrine or other medical ICD-10 codes to obtain reimbursement for sex-rejecting procedures. This false portrayal of <a href=\"https:\/\/www.conservativenewsdaily.net\/breaking-news\/republican-attorneys-general-warn-maine-not-to-pursue-child-sex-change-sanctuary-bill\/\" title=\"Republican AGs caution Maine against pursuing child sex change sanctuary bill\">sex change interventions<\/a> under the guise of a legitimate endocrine disorder, for example, lacks medical validity.\u201d<\/p>\n<hr>\n<p>      Breccan F. Thies is the White House correspondent for The Federalist. He is a co-recipient of the 2025 Dao Prize for Excellence in Investigative Journalism. As an investigative journalist, he previously covered education and culture issues for the Washington Examiner and Breitbart News. He holds a degree from the University of Virginia and is a 2022 Claremont Institute Publius Fellow. You can follow him on X: @BreccanFThies.<\/p>\n<\/p><\/div>\n<p><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Do No Harm report says doctors may misuse codes to mask \u201ctrans\u201d care<\/p>\n","protected":false},"author":179,"featured_media":2597804,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_mo_disable_npp":"","fifu_image_url":"https:\/\/thefederalist.com\/wp-content\/uploads\/2026\/05\/IMG_5704.jpg","fifu_image_alt":"","footnotes":""},"categories":[33651],"tags":[75864,78956,78957,72829],"class_list":["post-2597803","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-the-western-journal","tag-child-protection-2","tag-genital-mutilation-2","tag-healthcare-billing","tag-medical-ethics-2"],"fifu_image_url":"https:\/\/thefederalist.com\/wp-content\/uploads\/2026\/05\/IMG_5704.jpg","_links":{"self":[{"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/posts\/2597803","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/users\/179"}],"replies":[{"embeddable":true,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/comments?post=2597803"}],"version-history":[{"count":3,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/posts\/2597803\/revisions"}],"predecessor-version":[{"id":2597807,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/posts\/2597803\/revisions\/2597807"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/media\/2597804"}],"wp:attachment":[{"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/media?parent=2597803"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/categories?post=2597803"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/tags?post=2597803"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}