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ICD-10 Guide
ICD-10 CodesL65.1

L65.1

Billable

Anagen effluvium

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

Code Description

ICD-10 L65.1 is a billable code used to indicate a diagnosis of anagen effluvium.

Key Diagnostic Point:

Anagen effluvium is a type of hair loss characterized by the rapid shedding of hair during the anagen (growth) phase of the hair cycle. This condition can result from various factors, including chemotherapy, radiation therapy, autoimmune disorders, and severe stress. Clinically, patients may present with diffuse hair thinning or patchy hair loss, often noticeable within weeks of the triggering event. The scalp and hair follicles are primarily affected, with the hair shafts becoming weak and brittle, leading to increased shedding. Disease progression can vary; while some individuals may experience complete regrowth after the underlying cause is addressed, others may have prolonged hair loss. Diagnostic considerations include a thorough patient history, physical examination, and possibly a scalp biopsy to rule out other causes of hair loss. Laboratory tests may also be warranted to identify underlying systemic conditions contributing to hair loss. Early diagnosis and intervention are crucial to managing anagen effluvium effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors
  • Documentation gaps
  • Billing challenges

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

Oncology

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

Anagen effluvium can significantly impact patients' quality of life, leading to psychological distress and social withdrawal due to visible hair loss. Understanding its epidemiology is crucial, as it can affect various populations, particularly those undergoing cancer treatment. Effective management and awareness can improve patient outcomes and reduce healthcare utilization by addressing the condition promptly and effectively.

ICD-9 vs ICD-10

Anagen effluvium can significantly impact patients' quality of life, leading to psychological distress and social withdrawal due to visible hair loss. Understanding its epidemiology is crucial, as it can affect various populations, particularly those undergoing cancer treatment. Effective management and awareness can improve patient outcomes and reduce healthcare utilization by addressing the condition promptly and effectively.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the medical necessity for treatments, such as topical therapies or consultations with specialists, is clearly documented. Common denials may arise from insufficient documentation or failure to demonstrate the link between the diagnosis and the treatment rendered. Best practices include maintaining comprehensive records of patient interactions, treatment plans, and follow-up assessments to substantiate claims.

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 L65.1?

L65.1 specifically covers anagen effluvium, which can be triggered by factors such as chemotherapy, radiation, autoimmune diseases, and severe stress. It is important to differentiate it from other types of hair loss, such as telogen effluvium or alopecia areata.

When should L65.1 be used instead of related codes?

L65.1 should be used when hair loss is specifically due to the disruption of the anagen phase of the hair cycle. It is essential to use this code when the hair loss is rapid and linked to identifiable triggers, differentiating it from other hair loss conditions.

What documentation supports L65.1?

Documentation for L65.1 should include a detailed patient history, physical examination findings, and any relevant laboratory or imaging studies that support the diagnosis of anagen effluvium. Notes on the patient's treatment history, especially regarding chemotherapy or other triggering factors, are also crucial.