F63.3 vs L65
F63.3 and L65 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on L65
trichotillomania (F63.3)
F63.3
Trichotillomania
Billable
- Chapter 5
- Mental, Behavioral and Neurodevelopmental disorders
- Section
- F60-F69
Use when the record says
- Hair plucking
Indexed under
- Hair-pulling, pathological (compulsive)
- Trichotillomania
- Hair › plucking
L65
Other nonscarring hair loss
Not billable
- Chapter 12
- Diseases of the skin and subcutaneous tissue
- Section
- L60-L75
These two codes sit in different chapters of the Tabular List, which is usually the clearest signal that they describe different underlying processes rather than different degrees of the same one.
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027