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MA11.046c, Hair Transplants and Cranial Prostheses (Wigs)
Act
by Oct 1, 2024 (retroactive)
Effective date
Oct 1, 2024
Identified
Jun 19, 2026
Summary
Independence Blue Cross updated ICD-10 diagnosis codes for hair transplant coverage under MA11.046c, replacing the generic code L66.8 (Other cicatricial alopecia) with two more specific codes: L66.81 (Central centrifugal cicatricial alopecia) and L66.89 (Other cicatricial alopecia). The coverage policy itself remains unchanged—hair transplants are covered only for medically necessary cases (trauma, surgery, cicatricial alopecia), while wigs remain non-covered. Cranial prostheses (wigs) continue to be non-covered.
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What to do
by Oct 1, 2024 (retroactive) · 6 steps
01Billing team must update diagnosis code mapping in billing software to remove L66.8 and replace with L66.81 or L66.89 depending on clinical documentation.
02When processing hair transplant claims (CPT 15775, 15776) for Independence Blue Cross Medicare Advantage members, verify that submitted diagnosis codes use only the updated ICD-10 codes—claims using the deleted code L66.8 may be rejected or require correction.
03Verify that all prior authorizations and claim submissions for cicatricial alopecia cases use L66.81 (central centrifugal) or L66.89 (other) rather than the obsolete L66.8.
04Continue to deny all claims for CPT 15775/15776 when diagnosis does not meet medical necessity criteria (physical trauma, surgery, or cicatricial alopecia diseases).
05Continue to deny all wig claims (HCPCS A9282) as non-covered.
06Update internal coding reference materials and train billing staff on the new ICD-10 code structure.
Codes mentioned
1577515776A9282L66.8L66.81L66.89
Original notice
MA11.046c, Hair Transplants and Cranial Prostheses (Wigs)
medpolicy.ibx.com · Always check the source before changing claims.