Understanding Dermatillomania (Excoriation Disorder, Skin Picking Disorder) diagnosis? Find information on Dermatillomania symptoms, treatment, and clinical documentation. This resource covers medical coding for Excoriation Disorder and Skin Picking Disorder, supporting healthcare professionals in accurate diagnosis and documentation. Learn about Dermatillomania criteria for diagnosis and effective treatment options for patients. Explore Dermatillomania resources for healthcare providers and individuals seeking information on this skin picking condition.
Also known as
Obsessive-compulsive and related
Includes obsessive-compulsive disorder and body-focused repetitive behaviors.
Other disorders of skin and subcutaneous
Encompasses various skin conditions not classified elsewhere.
Disorders of adult personality and behavior
Includes personality disorders and habit/impulse control issues.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the patient's presentation consistent with recurrent skin picking resulting in skin lesions?
Yes
Are the skin picking attempts unsuccessful at stopping?
No
Do not code Dermatillomania. Evaluate for other conditions causing skin lesions.
When to use each related code
| Description |
|---|
| Recurrent skin picking resulting in lesions. |
| Repetitive hair pulling resulting in hair loss. |
| Obsessive-compulsive disorder with obsessions and compulsions. |
Coding dermatillomania lacks severity specificity (mild, moderate, severe) impacting reimbursement and treatment plans.
Dermatillomania often coexists with OCD or anxiety. Missing these impacts accurate coding and patient care.
Miscoding skin picking as a symptom of another condition rather than dermatillomania leads to inaccurate data.
Q: How can I differentiate between Dermatillomania (Excoriation Disorder) and other body-focused repetitive behaviors (BFRBs) like trichotillomania or onychophagia in a clinical setting?
A: Differentiating Dermatillomania from other BFRBs requires careful clinical assessment focusing on the target behavior and associated features. While all BFRBs involve repetitive, compulsive behaviors, Dermatillomania specifically involves skin picking, resulting in visible skin lesions. Trichotillomania involves hair pulling, while onychophagia is characterized by nail biting. Look for skin damage like scabs, scars, or infections, which are characteristic of Dermatillomania. Consider patient-reported emotional triggers, such as anxiety or stress, common to many BFRBs, and assess the level of functional impairment. The Skin Picking Scale and the Milwaukee Inventory for Subtypes of Trichotillomania can be useful diagnostic aids. Explore how comprehensive behavioral assessments can aid in accurate diagnosis and treatment planning for Dermatillomania and other related BFRBs.
Q: What are the most effective evidence-based treatment options for adults with Dermatillomania (Skin Picking Disorder) that I can implement in my practice?
A: Evidence-based treatments for Dermatillomania primarily involve Habit Reversal Training (HRT) and Cognitive Behavioral Therapy (CBT). HRT teaches patients to become more aware of their picking urges and implement competing responses, like clenching their fists or holding a stress ball. CBT addresses the underlying thoughts and feelings that contribute to skin picking. Acceptance and Commitment Therapy (ACT) can also be helpful in managing difficult emotions and reducing avoidance behaviors. Consider implementing these techniques in your practice, tailoring the approach to individual patient needs. Pharmacotherapy, such as selective serotonin reuptake inhibitors (SSRIs), may be considered as an adjunctive treatment in some cases, though more research is needed. Learn more about integrating HRT and CBT techniques into your practice for effective Dermatillomania treatment.
Patient presents with recurrent skin picking resulting in skin lesions, consistent with a diagnosis of Dermatillomania (Excoriation Disorder, Skin Picking Disorder). The patient reports significant distress and impairment in social and occupational functioning due to this behavior. Onset of skin picking behavior was reported as [age of onset], and the patient identifies [triggers, e.g., stress, anxiety, boredom] as exacerbating factors. Lesions are primarily located on [location of lesions, e.g., face, arms, legs] and vary in presentation from excoriations and scabs to deeper wounds. The patient denies primary dermatological conditions causing the lesions and acknowledges the self-inflicted nature of the skin damage. Differential diagnoses considered include obsessive-compulsive disorder, body dysmorphic disorder, and other body-focused repetitive behaviors. Clinical assessment indicates the patient meets DSM-5 criteria for Dermatillomania. Treatment plan includes cognitive behavioral therapy (CBT) focusing on habit reversal training and stimulus control techniques. Patient education regarding skin care and wound management was provided. Follow-up scheduled in [duration, e.g., two weeks] to assess treatment response and adjust the plan as needed. ICD-10 code L98.1 assigned. Medical necessity for ongoing treatment will be reevaluated at subsequent appointments based on patient progress and functional impairment.