ICD-10 code for excoriation (skin-picking) disorder
Living with excoriation disorder can feel isolating and overwhelming, affecting both physical well-being and emotional health. For many who experience this condition, finding the right clinical support starts with proper diagnosis. Healthcare providers play a crucial role in this process by understanding and accurately identifying this often-misunderstood condition.
The ICD-10 code for excoriation disorder is F42.4. This code appears within the obsessive-compulsive and related disorders section, reflecting our modern understanding of skin picking as a body-focused repetitive behavior with both compulsive and impulsive features.
According to recent epidemiological research, excoriation disorder affects between 3% of the general population, with approximately 55% of diagnosed individuals being female. The condition typically begins in early adolescence, though onset can occur at any age. Despite its prevalence, many individuals struggle silently with symptoms for years before seeking professional help.
When to use F42.4 for excoriation disorder
Healthcare providers should use this code when documenting cases where patients demonstrate:
- Recurrent skin picking leading to tissue damage
- Multiple attempts to decrease or stop picking behavior
- Clinically significant distress or functional impairment
- Symptoms not better explained by another mental disorder or medical condition
Excoriation disorder vs. dermatitis artefacta
While both conditions involve self-induced skin lesions, dermatitis artefacta involves conscious production of wounds for external gain or attention-seeking purposes. Excoriation disorder, in contrast, is characterized by compulsive picking behaviors that persist despite efforts to stop.
Excoriation disorder vs. delusional parasitosis
In delusional parasitosis, skin damage results from false beliefs about infestation. Unlike excoriation disorder, these individuals are convinced of external causes and may resist psychological interventions.
ICD-10 codes for other OCD-related diagnoses
- F42.0 Obsessive-compulsive disorder
- F42.2 Mixed OCD
- F42.3 Hoarding disorder
- F42.8 Other obsessive-compulsive disorders
- F42.9 Obsessive-compulsive disorder, unspecific
Interventions and CPT codes for treatment
Individual psychotherapy
Evidence-based psychotherapy remains the primary treatment approach, with cognitive-behavioral therapy (CPT) and exposure and response prevention (ERP) being common modalities for skin-picking disorder. Psychotherapy sessions are typically coded as:
- 90832: 30-minute sessions focusing on behavioral strategies and trigger identification
- 90834: 45-minute sessions addressing both behaviors and underlying anxiety
- 90837: 60-minute sessions for complex cases requiring comprehensive treatment
Medication management
When clinically indicated, psychiatric medication may be prescribed to address underlying anxiety or obsessive-compulsive symptoms. Common medication management services include:
- 99213: Office visit, 15 minutes (for routine medication monitoring)
- 99214: Office visit, 25 minutes (for more complex medication adjustments)
- 99215: Office visit, 40 minutes ( for comprehensive medication review and changes)
These medication management sessions should be integrated with ongoing psychotherapy for optimal treatment outcomes. Medication alone is rarely sufficient and works best as part of a comprehensive treatment approach that includes behavioral interventions.
Supporting clients with excoriation disorder
The impact of excoriation disorder extends beyond physical scarring to affect social relationships, occupational functioning, and emotional well-being. Maintaining accurate clinical documentation is crucial for ensuring continuity of care and supporting insurance coverage. This enables providers to focus more time on delivering effective, evidence-based treatments rather than administrative challenges.
Upheal is an AI-powered clinical documentation platform that helps behavioral health providers maintain precise diagnostic coding while reducing administrative burden. By streamlining the documentation process, Upheal allows clinicians to focus more energy on what matters most — supporting their clients' recovery journey.
