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ICD-10 Guide
ICD-10 CodesL63.1

L63.1

Billable

Alopecia universalis

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 L63.1 is a billable code used to indicate a diagnosis of alopecia universalis.

Key Diagnostic Point:

Alopecia universalis is a severe form of alopecia areata characterized by the complete loss of hair on the scalp and body. Clinically, patients present with sudden onset of hair loss, often accompanied by a smooth, hairless scalp and loss of body hair, including eyebrows and eyelashes. The condition is thought to be an autoimmune disorder where the immune system mistakenly attacks hair follicles, leading to hair loss. The pathophysiology involves a complex interplay of genetic predisposition and environmental triggers, although the exact cause remains unclear. Disease progression can vary; some patients may experience spontaneous regrowth, while others may have persistent or recurrent hair loss. Diagnostic considerations include a thorough clinical examination, patient history, and sometimes a scalp biopsy to rule out other conditions. Differential diagnoses include other forms of alopecia, such as androgenetic alopecia and telogen effluvium, which can present similarly but have distinct underlying mechanisms.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Alopecia universalis can be challenging to diagnose due to its similarity to other hair loss conditions.
  • Treatment complexity: Management may involve topical immunotherapy, corticosteroids, or other systemic treatments, which require careful monitoring.
  • Documentation requirements: Comprehensive documentation of patient history, clinical findings, and treatment response is essential.
  • Coding specificity: Accurate coding requires distinguishing alopecia universalis from other alopecia types.

Audit Risk Factors

  • Common coding errors: Misclassification of alopecia universalis as other types of alopecia.
  • Documentation gaps: Incomplete patient history or lack of follow-up documentation.
  • Billing challenges: Potential denials due to insufficient evidence of medical necessity for treatment.

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Primary Care

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Alopecia universalis significantly impacts patients' quality of life, leading to psychological distress and social stigma due to visible hair loss. It affects a small percentage of the population, but its unpredictable nature can lead to increased healthcare utilization as patients seek various treatment options. Understanding the epidemiology and management of alopecia universalis is crucial for improving patient outcomes and implementing effective quality measures in dermatological care.

ICD-9 vs ICD-10

Alopecia universalis significantly impacts patients' quality of life, leading to psychological distress and social stigma due to visible hair loss. It affects a small percentage of the population, but its unpredictable nature can lead to increased healthcare utilization as patients seek various treatment options. Understanding the epidemiology and management of alopecia universalis is crucial for improving patient outcomes and implementing effective quality measures in dermatological care.

Reimbursement & Billing Impact

Alopecia universalis significantly impacts patients' quality of life, leading to psychological distress and social stigma due to visible hair loss. It affects a small percentage of the population, but its unpredictable nature can lead to increased healthcare utilization as patients seek various treatment options. Understanding the epidemiology and management of alopecia universalis is crucial for improving patient outcomes and implementing effective quality measures in dermatological care.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for L00-L99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for L00-L99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by L63.1?

L63.1 specifically covers alopecia universalis, which is characterized by total hair loss on the scalp and body. It is distinct from other forms of alopecia, such as alopecia areata (L63.0) and androgenetic alopecia (L65).

When should L63.1 be used instead of related codes?

L63.1 should be used when a patient presents with complete hair loss on the scalp and body, differentiating it from other alopecia types that may not involve total hair loss.

What documentation supports L63.1?

Documentation should include a detailed patient history, clinical examination findings, and any relevant laboratory or biopsy results that confirm the diagnosis of alopecia universalis.