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ICD-10 Guide
ICD-10 CodesL64.9

L64.9

Billable

Androgenic alopecia, unspecified

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

Code Description

ICD-10 L64.9 is a billable code used to indicate a diagnosis of androgenic alopecia, unspecified.

Key Diagnostic Point:

Androgenic alopecia, unspecified (L64.9) is a common form of hair loss characterized by a progressive thinning of hair, primarily affecting the scalp. It is often referred to as male-pattern baldness or female-pattern baldness, depending on the gender of the individual. The condition is influenced by genetic predisposition and hormonal factors, particularly androgens, which play a crucial role in hair follicle miniaturization. Clinically, patients may present with a receding hairline, thinning at the crown, or diffuse hair loss across the scalp. The disease progression varies, with some individuals experiencing rapid hair loss while others may have a more gradual decline over years. Diagnostic considerations include a thorough patient history, physical examination, and, if necessary, scalp biopsy to rule out other causes of hair loss such as alopecia areata or telogen effluvium. The diagnosis of androgenic alopecia is often made based on clinical findings alone, particularly in typical cases. Understanding the anatomy involved, particularly the hair follicles and their response to androgens, is essential for effective management and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires differentiation from other types of alopecia.
  • Treatment complexity: Moderate, with various treatment options including topical minoxidil, oral finasteride, and hair transplant.
  • Documentation requirements: Requires detailed patient history and clinical findings.
  • Coding specificity: Moderate, as it is important to specify the type of alopecia when possible.

Audit Risk Factors

  • Common coding errors: Misuse of related codes or failure to specify the type of alopecia.
  • Documentation gaps: Incomplete patient history or lack of clinical evidence.
  • Billing challenges: Potential denials due to insufficient documentation or incorrect code selection.

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

Endocrinology

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Androgenic alopecia has significant clinical implications, affecting not only the physical appearance but also the psychological well-being of individuals. It is prevalent in both men and women, with varying degrees of impact on quality of life. Understanding the epidemiology of this condition can aid in developing targeted interventions and improving healthcare utilization patterns. Quality measures may include patient-reported outcomes and satisfaction with treatment, highlighting the importance of addressing this common dermatological condition.

ICD-9 vs ICD-10

Androgenic alopecia has significant clinical implications, affecting not only the physical appearance but also the psychological well-being of individuals. It is prevalent in both men and women, with varying degrees of impact on quality of life. Understanding the epidemiology of this condition can aid in developing targeted interventions and improving healthcare utilization patterns. Quality measures may include patient-reported outcomes and satisfaction with treatment, highlighting the importance of addressing this common dermatological condition.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the treatment provided, with some treatments requiring prior authorization. Common denials may arise from insufficient documentation or incorrect code selection, so it is essential to provide detailed clinical notes and any relevant diagnostic tests. Coding best practices include using the most specific code available and ensuring that all services rendered are well-documented to support the medical necessity of the treatment.

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 L64.9?

L64.9 covers unspecified androgenic alopecia, which may include cases where the pattern of hair loss is not clearly defined. It is important to differentiate this from other types of alopecia, such as alopecia areata or telogen effluvium, which have different underlying causes and treatment approaches.

When should L64.9 be used instead of related codes?

L64.9 should be used when the specific type of androgenic alopecia is not documented or when the clinical presentation does not fit the criteria for male-pattern (L64.0) or female-pattern (L64.1) baldness. It is essential to ensure that the documentation supports the use of this unspecified code.

What documentation supports L64.9?

Documentation should include a comprehensive patient history detailing the onset and pattern of hair loss, physical examination findings, and any previous treatments attempted. Photographic evidence may also be beneficial in supporting the diagnosis.