The treatment of hair loss is generally a cosmetic problem, not a medical one; however, making the appropriate diagnosis is a matter of some significance. Therefore, QualChoice will continue to cover all visits to a PCP with any diagnosis related to hair loss. This will assure the patient access to have a presumptive diagnosis made.
Treatment of male or female pattern baldness with topical or systemic medications is not covered – the prescriptions for those medications will be denied for payment. Hair transplants are also not covered.
Treatment of medication-induced baldness is also not covered.
In the case of hair loss caused by a systemic illness, coverage will be provided for the treatment of the causative illness. Local treatment to ameliorate the hair loss will not be covered.
In the case that the hair loss is caused by a disease of the scalp which results in hair loss, treatment of the underlying dermatologic problem, including consultation with a dermatologist, will be covered. Local treatment specifically directed at the restoration of hair growth will not be covered.
Codes Used In This BI:
15775 Hair transplant punch grafts
15776 Hair transplant punch grafts