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ICD-10 Guide
ICD-10 CodesL66.10

L66.10

Billable

Lichen planopilaris, unspecified

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

Code Description

ICD-10 L66.10 is a billable code used to indicate a diagnosis of lichen planopilaris, unspecified.

Key Diagnostic Point:

Lichen planopilaris (LPP) is a chronic inflammatory condition affecting the hair follicles, leading to hair loss and scarring. It primarily presents as a variant of lichen planus, characterized by violaceous papules and plaques on the scalp. The condition can lead to significant hair thinning and bald patches, often accompanied by pruritus or discomfort. The pathophysiology involves an autoimmune response where lymphocytes attack the hair follicles, resulting in inflammation and subsequent fibrosis. Diagnosis is typically made through clinical examination and may be supported by scalp biopsy, which reveals lichenoid tissue changes and lymphocytic infiltrate. Disease progression can vary; some patients may experience spontaneous remission, while others may have persistent symptoms or progressive hair loss. Early diagnosis and intervention are crucial to prevent irreversible hair loss and improve patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and possibly biopsy for confirmation.
  • Treatment complexity: Management may involve topical corticosteroids, systemic medications, or phototherapy.
  • Documentation requirements: Detailed clinical notes and treatment plans are essential for accurate coding.
  • Coding specificity: Limited to unspecified cases; more specific codes exist for documented variants.

Audit Risk Factors

  • Common coding errors: Misuse of related codes or failure to specify the condition.
  • Documentation gaps: Incomplete clinical notes or lack of biopsy results.
  • Billing challenges: Potential denials due to insufficient documentation supporting the diagnosis.

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

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Documentation Requirements

CPT Code

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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

Lichen planopilaris can significantly impact patients' quality of life due to hair loss and associated psychological effects. Understanding its prevalence and management is crucial for dermatologists and primary care providers. Effective treatment can reduce healthcare utilization by preventing complications associated with untreated conditions, such as permanent hair loss. Epidemiological studies suggest that LPP may affect a small percentage of the population, but its impact on individual patients can be profound.

ICD-9 vs ICD-10

Lichen planopilaris can significantly impact patients' quality of life due to hair loss and associated psychological effects. Understanding its prevalence and management is crucial for dermatologists and primary care providers. Effective treatment can reduce healthcare utilization by preventing complications associated with untreated conditions, such as permanent hair loss. Epidemiological studies suggest that LPP may affect a small percentage of the population, but its impact on individual patients can be profound.

Reimbursement & Billing Impact

Reimbursement may depend on the specificity of the diagnosis and the supporting documentation provided. Common denials can occur if the documentation does not clearly establish the diagnosis or if the treatment provided is not adequately justified. Best practices include ensuring that all clinical notes are thorough, including details of the patient's symptoms, treatment responses, and any diagnostic tests performed.

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 L66.10?

L66.10 covers unspecified cases of lichen planopilaris, which may include various presentations of the condition without specific details on severity or extent.

When should L66.10 be used instead of related codes?

L66.10 should be used when the diagnosis of lichen planopilaris is confirmed but lacks specific details regarding the extent or type of lesions present.

What documentation supports L66.10?

Documentation should include clinical findings, patient history, treatment plans, and any biopsy results that confirm the diagnosis of lichen planopilaris.