F63.3
BillableTrichotillomania
HCC Category Mapping
RxHCCHCC 133 — Personality Disorders, Anxiety, and Other Specified Mental Disorders
0.000What This Code Means
A disorder involving recurrent hair pulling resulting in noticeable hair loss, often causing distress and repeated unsuccessful attempts to decrease the behavior.
Coding Tips
- •Ensure documentation specifies hair pulling is not due to a dermatological condition or another mental disorder
- •Note the presence of tension before pulling and relief or gratification afterward
Clinical Significance
Trichotillomania (hair-pulling disorder) is an impulse control disorder involving recurrent pulling of one's hair resulting in noticeable hair loss. It is now classified with obsessive-compulsive and related disorders in DSM-5 and is associated with significant distress, social embarrassment, and comorbid anxiety, depression, and other body-focused repetitive behaviors. Treatment typically involves habit reversal training and sometimes pharmacotherapy.
Documentation Requirements
- ✓Provider documentation of recurrent hair pulling resulting in hair loss
- ✓Evidence of repeated attempts to decrease or stop the behavior
- ✓Documentation of clinically significant distress or functional impairment caused by the hair pulling
- ✓Exclusion of hair loss due to dermatological conditions (alopecia areata, tinea capitis) or other medical causes
- ✓Treatment plan including behavioral therapy (habit reversal training) and/or pharmacologic management
Excludes 2 — Not included here, may code separately
- other stereotyped movement disorder (F98.4)
Commonly Confused Codes
L63.9 — Alopecia areata, unspecified; alopecia areata is autoimmune hair loss, not behavioralF98.4 — Stereotyped movement disorders; repetitive movements in children may involve hair pulling but as part of a broader stereotypy patternF42.x — Obsessive-compulsive disorder; while DSM-5 groups trichotillomania with OCD-related disorders, the ICD-10-CM code remains under impulse controlL65.9 — Nonscarring hair loss, unspecified; must differentiate behavioral from dermatological causes of hair loss