Cracking the Code

Coding Alopecia

Alopecia or hair loss can not only affect your scalp but also your entire body. It can also be temporary or permanent. Alopecia can be caused by hormonal changes, medical conditions, or aging, or it can be hereditary.  Alopecia is more common in men than women.

Alopecia areata is an autoimmune disease where the immune system mistakenly attacks hair follicles, causing hair loss. Telogen effluvium is alopecia caused by metabolic or hormonal stress or by medications. Code selection is based on the type of alopecia.

Signs and symptoms of hair loss may include gradual thinning on top of the head, circular or patchy bald spots, sudden loosening of hair, full-body hair loss, or patches of scaling that spread over the top of the scalp.

Q: A 23-year-old man complains he has premature hair loss. The provider suspects it is due to stress but is uncertain. What is the ICD-10-CM code that would be reported for the hair loss?
A: L64.8. Rationale: Alopecia is hair loss. We can find the correct code by looking for Loss (of)/hair, which directs us to see Alopecia. We then will look for Alopecia in the ICD-10-CM Alphabetic Index. Alopecia/premature L64.8. As always, we want to verify our code selection in the tabula list. L65.0 Telogen effluvium is hair loss due to stress, but the provider only suspects it is due to stress, so it is not coded.
Reference: FY 2023 ICD-10-CM codebook. Mayo Clinic.
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