Psychiatry Coding & Reimbursement Alert

Question: Our psychiatrist recently diagnosed a patient with “skin picking disorder.” Can you elaborate what this disorder is and how I should report this condition?

Michigan Subscriber

Answer: Skin picking disorder is also known as excoriation disorder. It is a disorder in which the patient will repeatedly scratch at their skin and cause excoriation with scar formation and discoloration. The patient will resort to skin picking spontaneously without any cause or due to some minor cause such as acne or an insect bite. The patient might resort to the skin picking when he/ she experiences any feelings of stress or anxiety and the disorder might affect the social functioning of the individual and cause disturbances in family and work circles.

There is no specific code in ICD-10 to report a diagnosis of “skin picking disorder.” Since it is a repetitive impulsive disorder similar to “trichotillomania,” you can report the condition using either F63.89 (Other impulse disorders) or F63.9 (Impulse disorder, unspecified). Another option that you can look at depending on payer choice is to use L98.1 (Factitial dermatitis) as the descriptor to this code includes “neurotic excoriation.”