ICD-10 stands for International Classification of Diseases, tenth revision. Health practitioners, medical personnel, and medical coders use the classification of diseases listed by the World Health Organization to assign codes on patient diagnosis. It provides a common language for diseases and conditions to enable efficient recording, monitoring, and reporting of disease and data retrieval across different regions, hospitals, and countries.
The purpose of the ICD 10 coding is to;
- Collect data for billing.
- Collect data for claims reimbursement
- Track public health conditions
- Enhance data for research on the epidemiology
- Have sufficient data to help make clinical decisions
- Identify any abuse or fraud, especially in patient care and claims reimbursement.
- Design payment systems and claim processing
Hair Loss ICD 10
In this hair loss ICD 10 feature, we will discuss the following:
- What is ICD-10-CM code L 65.9 – nonscarring hair loss, unspecified
- What is non-scarring hair loss
- Causes of non-scarring hair loss
- What is included in ICD 10 code L65.9 for non-scarring hair loss unspecified
- What is excluded in ICD 10 code L65.9 for non-scaring hair loss, unspecified
What is ICD 10 code L65.9 for non-scarring hair loss, unspecified?
Hair Loss ICD 10 code L65.9 in a WHO ICD 10 coding under diseases of the skin and subcutaneous tissue used to describe an unspecified diagnosis of non-scarring hair loss. Unspecified diagnosis refers to non-scarring hair loss whose clinical information is either unknown or unavailable.
Unspecified diagnosis may change later if more information about hair loss for the particular patient becomes available. For example, a patient who presents with non-scarring hair loss unspecified and coded under ICD 10 code L65.9 may have the coding change after laboratory testing, biopsy samples, or any other diagnostic tests that may have provided more information about the illness.
Non-scarring hair loss
Non-scarring hair loss refers to hair loss on the scalp without follicle destruction. Hair growth resumes after treating the cause of hair loss. Various factors may cause non-scarring hair loss.
These factors are:
- Nutritional deficiency
- Hormonal deviation
- Autoimmune response
- Chronic systemic illness
Micronutrients such as vitamin D, zinc, B12, and iron and macros such as proteins, fats, and carbohydrates play a role in hair growth and development. Deficiency or insufficiency of these elements could lead to hair loss on the scalp or other body parts like the eyebrows, axillary region, eyelashes, beard, and pubic region.
Hormonal deviation, Thyroid hormone, cortisol, sex hormones such as testosterone, sex hormone-binding globulin, and estrogen promote hair growth in one way or another. Hair loss occurs with low hormonal levels or higher than optimal levels.
Stress could be psychological, emotional, or physical. Stress induces inflammation on the scalp, creates an unconducive environment for the hair follicles to thrive, and eventually causes hair loss. Stress also causes the hair to prematurely shift from the growing phase to the shedding phase causing diffuse loss. Stressors could be due to childbirth, fever, surgery, or grief. Acute or chronic stress could lead to loss of hair.
In autoimmune responses, the body’s immune system mistakenly identifies normal follicle cells as foreign bodies and initiates an immune attack. The hair follicle cells are crippled in the process and stop producing hair. Hair grows back once the immune attack resolves.
Chronic systemic illness
Diseases such as systemic lupus erythematosus, Crohn’s disease, syphilis, and leprosy could result in hair loss.
Hair loss can also result from medications such as chemotherapy used to treat cancer and other various diseases.
Lack of sufficient hemoglobin in the body may cause hair loss.
What is included in ICD 10 code L65.9?
Some of the clinical terms used to identify the correct diagnosis under the ICD10 L65.9 coding for non-scarring hair loss are as follows;
|Alopecia areata||Abnormal hair loss on the scalp or any other part of the body. It is normal to lose 50-100 strands of hair daily.|
|Alopecia localis||Loss of hair in patches on the scalp|
|atrichia||Congenital or early loss of hair in patches|
|Chronic diffuse alopecia||Hair shedding on the scalp that persists for a long time or keeps recurring|
|Diffuse alopecia||Hair shedding on the scalp without defined patches|
|Diffuse loss of scalp hair||Hair shedding on the scalp|
|Failure of hair growth||Lack of hair growth on the scalp or any other part of the body|
|Follicular hamartoma with alopecia||Malformation of the hair follicles restricted to the dermis. It is associated with systemic illnesses such as systemic lupus erythematosus and myasthenia gravis|
|Frostbite alopecia||Hair loss from cold thermal injuries such as cold caps or cryotherapy|
|Hereditary hypotrichosis||There is little or no hair growth on the scalp, eyebrows, and the edge of the eyelids. Hair loss may also be on any other body part where hair grows typically and has a genetic predisposition.|
|Hypogonadotropic hypogonadism with frontoparietal alopecia syndrome||Hair loss on the scalp or any other part of the body is associated with decreased functionality of the gonads.|
|Hypotrichosis||Hair loss on the scalp, eyebrows, eyelids, or any other body part where hair usually grows.|
|Hypotrichosis with keratosis pilaris||Hair loss on the scalp or any other part of the body is associated with dry, rough patches with tiny bumps characteristic of keratosis pilaris condition.|
|Lack of beard growth||Compete for the absence of beard hair in males after puberty.|
|Loss of axillary hair||Hair loss on the axillary region after puberty|
|Loss of body hair||Hair loss on areas that normally have hair growth.|
|Loss of hair||Hair loss on areas that previously had hair growth.|
|Loss of pubic hair||Hair loss on the pubic region after puberty|
|Loss of scalp hair||Hair loss on the scalp. It could be complete for loss or partial loss.|
|Non-scarring alopecia||Hair loss is where the hair follicles are not damaged.|
|Nutritional alopecia||Loss of hair caused by deficiency of vital nutrients.|
|Partial failure of hair growth||Lack of hair growth on parts of areas that normally grow hair but not entire areas.|
|Partial loss of hair||Loss of hair on parts that typically grow hair but not in entirety.|
|Patchy loss of scalp hair||Loss of hair is defined or irregular patches on the scalp|
|Peroneal alopecia||Loss of hair on the sides and front of the leg mostly following peroneal nerve site.|
|Temporal hair recession||Loss of hair along the temporal region of the scalp|
|Vitamin D defendant rickets||Hair loss in patients suffering from vitamin D dependant rickets.|
|Baldness||Loss of hair on the scalp|
|Eyelid hypotrichosis||Loss of hair on the eyelids|
|Male pattern alopecia||Loss of hair in men and on the scalp in a defined pattern|
In circumstances where the diagnosis is not available for non-scarring hair loss, ICD-10 coding allows for the description of signs and symptoms.
What is excluded in Hair Loss ICD 10 code L65.9?
Certain conditions are not covered by the ICD- 10 code L65.9. These conditions are determined not covered as they do not fall under the classification and the definition of non-scarring hair loss. ICD-10 code L65. 9 for nonscarring hair loss, unspecified excludes trichotillomania and normal hair loss.
adverse effects or complications
Trichotillomania, known as ‘trich,’ is a type of hair loss caused by an unconscious, compulsive urge to pull out one’s hair. Hair pulling may happen on the scalp, eyebrows, eyelids, or any other body part where hair usually grows.
Trichotillomania patients report feeling a sense of relief, pleasure, or satisfaction after the hair is pulled. The compulsive hair-pulling accompanies cues such as when reading, watching, or deep thinking.
Signs and symptoms of trichotillomania
- The compulsive urge to pull the hair
- Increased tension before pulling or when one tries to resist the pulling
- Sense of pleasure after the hair is pulled
- Irregular patches of hair loss on the scalp, eyebrows, or eyelids, mainly on the dominant hand side.
Trichotillomania is categorized under disorders of adult personality and behavior ICD-10 F60-F65.
Normal hair loss
Normal hair loss is when one loses 50-100 hair strands in one day. Hair normally grows in a cycle that consists of three stages;
- and telogen
During the anagen phase, hair is actively growing. The cells inside the hair follicles going through mitosis differentiate and form the hair strand which grows upwards out of the scalp. 82% of all follicles on the scalp are in the anagen phase at any given time. This phase lasts 2-6 years. The length of the growth phase is genetically determined.
Catagen is the transition phase where hair stops actively growing and prepares to move to a resting phase. This phase lasts 2-3 weeks. 10% of all the hair follicles on the scalp are in this phase.
Telogen is the resting phase. The hair strand detaches from the hair follicle and is removed from the scalp through combing, styling, or handling hair. Telogen lasts for three months and 1% of hair, which makes up 100-150 strands.
Adverse effects or complication
Non-scarring hair loss following adverse effects from drug poisoning, drug reactions, underdosing effects, medicaments, and hormonal therapy are excluded from the ICD 10 code l65.9.
Adverse effects refer to undesired effects after taking a particular drug, treatment, or intervention, such as surgery. This diagnosis is documented under poisoning by adverse effects of and underdosing drugs, medicaments, and biological substances ICD-10 Code range T36-T50.
Hair Loss ICD 10 code L65.9 is a billing code that helps healthcare workers to fill in patient data regarding non-scarring hair loss that is unspecified. Hospitals and healthcare institutions use this data for billing, reimbursement, and disease monitoring.
Celestine is certified by the International Association of Trichologists (IAT). She has written articles on hair and scalp health to create awareness. Celestine was a key note speaker at the first Virtual World Trichology Society Summit in May 2021 speaking about hair transplant techniques on afro ethnic hair.