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ICD 10 Code for Hair Loss: A Simple Guide for Medical Coders

Stanley Efrem

Mar 27, 2025

Approximately 6.8 million Americans suffer from alopecia areata, making it one of the most common autoimmune disorders that cause unpredictable hair loss. Medical coders play a vital role in maintaining accuracy with ICD 10 codes for hair loss to document diagnosis and treatment properly.

Diagnostic codes for hair loss conditions have demonstrated exceptional reliability, achieving a 97% positive predictive value in alopecia areata cases. The coding options have expanded through recent updates, and new ICD-10 codes will come into effect in October 2024 for conditions like central centrifugal cicatricial alopecia (CCCA) and frontal fibrosing alopecia (FFA). This piece will help you master the complete range of hair loss diagnosis codes to ensure precise documentation for alopecia and related conditions of all types.

Understanding Hair Loss ICD-10 Code Categories

Medical professionals use the World Health Organization's ICD-10 classification system to document hair loss conditions with precision. The system divides hair loss into four main categories, each with specific diagnostic codes.

Alopecia areata codes (L63.0-L63.9)

These codes represent autoimmune-related hair loss conditions that show inflammatory patchy areas. The category has:

L63.0 - Alopecia (capitis) totalis: Complete loss of hair on the scalp
L63.1 - Alopecia universalis: Total loss of hair on the entire body
L63.2 - Ophiasis: Hair loss in a band-like pattern around the sides and back of the head
L63.8 - Other alopecia areata: For variants not specified elsewhere
L63.9 - Alopecia areata, unspecified: When the specific type is undetermined

Medical professionals use these codes to document conditions where hair loss appears in well-defined, often round patches with normal skin underneath.

Androgenetic alopecia codes (L64.0-L64.9)

Hormone-related hair loss, such as male-pattern baldness, belongs to this category:

L64.0 - Drug-induced androgenic alopecia
L64.8 - Other androgenic alopecia
L64.9 - Androgenic alopecia, unspecified

Men and women experience this type of hair loss differently. Men typically show a receding hairline that forms an "M" shape with crown thinning. Women usually develop diffuse thinning at the top of the head and their middle part widens [1].

Other non-scarring hair loss codes (L65.0-L65.9)

The hair follicles remain intact in these non-scarring conditions:

L65.0 - Telogen effluvium: Excessive shedding from stress or shock
L65.1 - Anagen effluvium: Hair loss during the growth phase (often chemotherapy-related)
L65.2 - Alopecia mucinosa
L65.8 - Other specified nonscarring hair loss
L65.9 - Nonscarring hair loss, unspecified (includes Alopecia NOS)

Hair regrowth remains possible in these cases because the follicles stay intact.

Cicatricial alopecia codes (L66.0-L66.9)

Scarring alopecia leads to permanent hair loss as the follicles get destroyed:

L66.0 - Pseudopelade
L66.1 - Lichen planopilaris (includes subtypes like frontal fibrosing alopecia)
L66.2 - Folliculitis decalvans
L66.3 - Perifolliculitis capitis abscedens
L66.4 - Folliculitis ulerythematosa reticulata
L66.8 - Other cicatricial alopecia (includes central centrifugal cicatricial alopecia)
L66.9 - Cicatricial alopecia, unspecified

Small hairless areas that may grow larger over time characterize these conditions. They result from immune disorders, burns, congenital conditions, or pathogens [3].

Medical coders who understand these categories can select the most specific code. This improves clinical documentation, treatment planning, and insurance reimbursement. The correct hair loss diagnosis code will give patients appropriate care based on their condition.

Coding for Different Types of Hair Loss

Doctors need to understand why hair loss happens to select the right ICD 10 codes for hair loss. Studies that validate clinical accuracy show different success rates for hair loss diagnostic codes, and precise coding makes a big difference.

Autoimmune-related hair loss diagnosis codes

Autoimmune alopecia stands as one of the most common types of hair loss. This condition affects approximately 6.8 million people in the United States [4]. The L63 series codes specifically target these conditions with impressive diagnostic accuracy. The code 704.01 (ICD-9) shows 97% positive predictive value (PPV), which proves its reliability [5].

ICD-10 codes' accuracy varies substantially:

L63.9 (Alopecia areata, unspecified): 93% PPV [5]
L63.8 (Other alopecia areata): 91% PPV [5]
L63.1 (Alopecia universalis): 86% PPV [5]
L63.0 (Alopecia totalis): 64% PPV [5]

Medical professionals should use L63.9 and L63.8 codes because they provide more reliable results than specific subtypes [5].

Stress and trauma-induced hair loss

Metabolic or hormonal stress often leads to temporary hair loss. Code L65.0 (Telogen effluvium) addresses stress-induced hair shedding specifically [6]. Hair typically grows back once the stress factor disappears, unlike autoimmune conditions.

These conditions show non-scarring hair loss where follicles stay intact, which makes regrowth possible. Healthcare providers should document the connection between stress factors and hair loss patterns clearly to prove medical necessity.

Age and hormone-related baldness

The L64 series codes cover male-pattern baldness and hormone-related hair thinning, known as androgenic alopecia [7]. L64.9 addresses unspecified androgenic alopecia, while L64.0 applies to drug-induced cases [8].

Changing sex hormones cause this type of hair loss, especially in older people [9]. Genetic factors play a crucial role for patients under 30 years old. Studies show almost 40% have at least one family member with the same condition [4].

Accurate code selection requires proper documentation of pattern recognition. Men typically show M-shaped receding hairlines, while women experience diffuse thinning with widening of the middle part.

New Hair Loss ICD-10 Codes for 2025

October 2024 marks the most important milestone in medical coding for hair loss conditions with the introduction of two groundbreaking ICD-10 codes specifically for scarring alopecias. These new codes build on years of advocacy and will transform how doctors diagnose, track, and treat these conditions.

Central centrifugal cicatricial alopecia (CCCA) - L66.81

The Centers for Disease Control and Prevention (CDC) has approved L66.81 as the official hair loss diagnosis code for Central Centrifugal Cicatricial Alopecia [10]. This condition affects women of African descent disproportionately and causes permanent, irreversible damage to hair follicles [11]. CCCA shows up as patches of permanent hair loss on the vertex or crown of the scalp that spread outward.

CCCA patients often experience itching, burning, redness, and scalp pain [11]. The condition can decrease quality of life and cause psychological distress due to changes in appearance and persistent symptoms. This new code will help track the condition's true prevalence, which doctors couldn't establish accurately before.

Frontal fibrosing alopecia (FFA) - L66.12

Code L66.12 is now 3 months old for Frontal Fibrosing Alopecia [12]. This new code became active on October 1, 2024, and serves as a billable/specific ICD-10-CM code that works for reimbursement purposes [12]. FFA (often abbreviated as FFA in medical charts) has a distinct pattern that medical coding systems struggled to track before.

This specific alopecia diagnosis code enables precise tracking of FFA cases, so research and treatment options will improve. According to ICD-10-CM coding rules, L66.12 applies to adult patients aged 15-124 years [12].

Implementation timeline and transition guidelines

These codes took effect on October 1, 2024, after CDC approval on June 15, 2023 [13]. The codes will remain valid for HIPAA-covered transactions throughout the fiscal year from October 1, 2024, through September 30, 2025 [14].

Medical coders should use these codes for all relevant diagnoses after the implementation date. Note that these codes replace older, less specific ones. Medical professionals need role-based training on these 2025 ICD-10-CM code changes that affect everyone involved in documentation, coding, and data analysis.

Documentation Requirements for Hair Loss Coding

Good documentation is the life-blood of successful hair loss diagnosis coding. Medical records need complete information to back up code selection and get reimbursement for alopecia treatments.

Everything in clinical findings to document

A full picture of ICD 10 code for hair loss needs specific clinical details. Your medical records should have:

Detailed physical exam findings that show hair loss patterns (patchy, diffuse, or patterned)
Results from diagnostic tests like pull tests, scalp biopsies, or light microscopy
Measurements using proven tools like the Severity of Alopecia Tool (SALT) score to measure hair loss extent
Clear indication if the condition scars or doesn't scar

When dealing with autoimmune conditions like alopecia areata, you should note supportive findings such as exclamation point hairs or hair loss in circular patches. Past studies show diagnostic accuracy varies substantially between alopecia subtypes. General codes (L63.9, L63.8) show better positive predictive values than specific subtypes.

What you need for accurate code selection

Your claims succeed when you pick the most specific hair loss ICD 10 code. Medical records should separate:

Hair loss that's temporary versus permanent
Conditions that scar versus those that don't
Why it happens (autoimmune, hormonal, stress-related)

Code selection needs clear documentation in the assessment or plan section. Question marks or unclear terms usually lead to denied claims. Research shows general codes work better than specific subtypes to build an alopecia areata group.

Proving medical necessity for treatment

Insurance companies often see hair loss treatments as cosmetic unless you really prove medical necessity. Your documentation should cover:

How severe the disease is (SALT scores under 50% mean mild alopecia areata)
Treatments that didn't work before
How it affects function or mental health
Other clinical features that change severity rating

You must keep all documentation in the patient's medical record and have it ready when asked. Getting treatments approved needs proof that matches insurance company rules, especially when you have treatments like intralesional injections that often get denied.

Conclusion

Medical coders just need to pay close attention to detail and maintain complete documentation for accurate hair loss diagnosis coding. They should focus on the difference between scarring and non-scarring conditions when choosing ICD-10 codes. We have a long way to go, but we can build on this progress with new specific codes for CCCA and FFA that help track these conditions better.

General codes like L63.9 and L63.8 are more accurate than specific subtypes. You should default to these general codes unless clinical evidence strongly supports a particular subtype. This approach will give a better documentation trail and higher claim acceptance rates.

Medical coders who keep up with these guidelines and maintain detailed records definitely help healthcare providers deliver better patient care. This also helps secure proper reimbursement for alopecia treatments.

FAQs

What is the ICD-10 code for general hair loss?

The ICD-10 code L65.9 is used for "Nonscarring hair loss, unspecified." This code is applicable when the specific type of hair loss is not determined, but the condition is known to be nonscarring, meaning hair regrowth is possible.

How are different types of hair loss coded in ICD-10?

ICD-10 provides specific code ranges for various types of hair loss. For instance, L63.0-L63.9 covers alopecia areata, L64.0-L64.9 is for androgenetic alopecia, L65.0-L65.9 addresses other nonscarring hair loss, and L66.0-L66.9 is used for cicatricial (scarring) alopecia.

What new ICD-10 codes for hair loss were introduced in 2025?

Two new ICD-10 codes were introduced in October 2024: L66.81 for Central Centrifugal Cicatricial Alopecia (CCCA) and L66.12 for Frontal Fibrosing Alopecia (FFA). These codes allow for more precise tracking and documentation of these specific scarring alopecia conditions.

What documentation is required for accurate hair loss coding?

Proper documentation for hair loss coding should include detailed physical examination findings, results from diagnostic tests, measurements using validated tools like the Severity of Alopecia Tool (SALT) score, and confirmation of whether the condition is scarring or nonscarring. The documentation should also clearly differentiate between temporary and permanent hair loss.

How can medical necessity for hair loss treatment be established?

To establish medical necessity for hair loss treatment, documentation must address disease severity (e.g., SALT scores), failed previous treatments, functional impairment or psychological impact, and any secondary clinical features affecting severity classification. This information helps justify the need for treatment beyond cosmetic purposes.