ICD-10 Code F65.51 – Sexual masochism (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code F65.51 – Sexual masochism
What it is
Use this code for a paraphilic disorder involving recurrent sexual arousal from being humiliated, beaten, bound, or otherwise made to suffer. The diagnosis applies when the pattern is persistent and clinically significant.
Clinical signs
Clinical features vary; refer to documentation. Commonly, records describe recurrent fantasies, urges, or behaviors centered on receiving pain, restraint, or degradation, with distress, impairment, or risk when the pattern is not consensual or controlled.
When to use this code
Assign F65.51 when the provider documents sexual masochism or sexual masochistic disorder as the diagnosis. Use it for outpatient, inpatient, or behavioral health notes that clearly identify the condition rather than a single behavior or preference. Check documentation if the chart only mentions sexual practices without a disorder diagnosis.
Do not use for
Do not use this code for consensual sexual activity without a documented disorder, or for general mental health concerns unrelated to sexual masochism. If the note is vague, check documentation.
Coding tip
Code only when the clinician documents the diagnosis, not merely a fetish, fantasy, or relationship detail.