ICD-10 Code F65.52 – Sexual sadism (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code F65.52 – Sexual sadism
What it is
Sexual sadism is a paraphilic disorder involving recurrent sexual arousal from another person’s physical or psychological suffering. Use this code only when the behavior causes distress, impairment, or harm and is documented as a disorder.
Clinical signs
Clinical features vary; refer to documentation. Typical records may describe persistent sadistic fantasies, urges, or behaviors, with arousal linked to humiliation, pain, or control of another person.
When to use this code
Use F65.52 when the clinician documents sexual sadism as the diagnosed condition, not just an isolated preference or fantasy. It may apply in psychiatric assessments, forensic evaluations, or behavioral health notes when the pattern is persistent and clinically significant.
If the record only mentions sexual behavior without clear diagnostic language, check documentation before coding. Confirm that the provider has identified the disorder and that the presentation is not better explained by another condition.
Do not use for
Do not use this code for consensual kink or BDSM practices without a diagnosed disorder. Do not assign it when the chart lacks evidence of distress, impairment, or clinical diagnosis; check documentation.
Coding tip
Look for explicit provider wording such as “sexual sadism disorder” or equivalent diagnostic terminology before assigning F65.52.