Pathology/Lab Coding Alert
Not All Hair Exams Are Equal
Question: We received a hair specimen that the pathologist evaluated under the microscope for a hair shaft abnormality for alopecia. The only hair exam code I’m familiar with is 87220 — is that the correct code?
Ohio Subscriber
Answer: No, you should not report a hair shaft exam for alopecia using 87220 (Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites [e.g., scabies]). The exam you describe is not for fungi or parasites, and does not mention a potassium hydroxide (KOH) wet mount.
A hair exam for alopecia is called a “trichogram”, and involves a microscopic exam to determine the telogen and anagen counts (i.e., the rest and growth cycle of the hair) as well as any hair shaft structural abnormalities. The correct code for this exam is 96902 (Microscopic examination of hairs plucked or clipped by the examiner [excluding hair collected by the patient] to determine telogen and anagen counts, or structural hair shaft abnormality).
The result of the test may reveal the reason for hair loss, which may be hereditary or due to malnutrition and or medication.
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Not All Hair Exams Are Equal
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