F42.4
BillableExcoriation (skin-picking) disorder
HCC Category Mapping
RxHCCHCC 133 — Personality Disorders, Anxiety, and Other Specified Mental Disorders
0.000What This Code Means
Excoriation disorder involves repetitive skin picking that causes noticeable skin damage, often performed unconsciously or in response to stress.
Coding Tips
- •Document evidence of skin lesions or scarring resulting from the picking behavior
- •Note whether the behavior is triggered by anxiety, stress, or occurs unconsciously
Clinical Significance
Excoriation (skin-picking) disorder is an OCD-related condition involving recurrent skin picking resulting in skin lesions, despite repeated attempts to stop. It can cause significant tissue damage, scarring, and secondary infections. This condition is distinct from skin picking secondary to dermatological conditions or substance use.
Documentation Requirements
- ✓Recurrent skin picking resulting in skin lesions
- ✓Repeated attempts to decrease or stop skin picking
- ✓Clinically significant distress or functional impairment
- ✓Skin picking not attributable to substances (e.g., methamphetamine) or another medical condition (e.g., scabies, dermatitis)
- ✓Skin picking not better explained by another mental disorder (e.g., body dysmorphic disorder, psychosis)
- ✓Description of affected body areas and extent of tissue damage
Excludes 1 — Do NOT code together
Commonly Confused Codes
L98.1 (Factitial dermatitis) — Factitial dermatitis may involve self-inflicted skin lesions but is coded under dermatology; F42.4 is the psychiatric diagnosisF63.3 (Trichotillomania) — Hair pulling vs. skin picking are separate OCD-related disordersF42.2 (Mixed obsessional thoughts and acts) — Classic OCD is distinct from excoriation disorder, though they can coexistF45.8 (Other somatoform disorders) — Neurotic excoriation is sometimes classified under somatoform disorders but F42.4 is preferred
Code Hierarchy
└F42Obsessive-compulsive disorder└F42.4Excoriation (skin-picking) disorder
└F42.4Excoriation (skin-picking) disorder