Hair Transplantation
DESCRIPTION
Hair transplantation involves harvesting small hair-bearing skin grafts from non-balding portions of the scalp and transferring them to the areas of baldness. Hair transplant candidates must have a donor site on the back or side of the head with healthy hair growing. Hair color, texture, and degree of curliness may affect the transplant result.
There are several hair transplant techniques available to achieve the desired appearance. Modest improvements in hair fullness are achieved with punch grafts, micro- or mini-grafts, slit grafts, and strip grafts. Greater hair coverage is achieved with pedicled and microvascular flaps, tissue expansion and scalp-reduction. These methods are associated with more risks.
Hair transplantation is generally accomplished in multiple sessions with several months between each session. Simple grafting procedures may be accomplished with local anesthesia, with or without sedation. Complex or extensive grafting, including tissue expansion and scalp-reduction, require general anesthesia. The procedure is usually done in an outpatient setting. The duration depends on the complexity of the surgery.
POLICY
Hair transplantation is considered cosmetic.
IMPORTANT REMINDER
We develop Medical Policies to provide guidance to Members and Providers. This Medical Policy relates only to the services or supplies described in it. The existence of a Medical Policy is not an authorization, certification, explanation of benefits or a contract for the service (or supply) that is referenced in the Medical Policy. For a determination of the benefits that a Member is entitled to receive under his or her health plan, the Member's health plan must be reviewed. If there is a conflict between the Medical Policy and a health plan, the express terms of the health plan will govern.
ADDITIONAL INFORMATION
The U. S. Food and Drug Administration (FDA) ban the implantation of prosthetic hair fibers.
SOURCES
American Society of Plastic Surgeons. (2007). Hair replacement. Retrieved October 11, 2007 from http://www.plasticsurgery.org/patients_consumers/procedures/HairReplacement.cfm.
American Society of Plastic Surgeons. (2007). Physician's guide to cosmetic surgery: Facial surgery and skin care surgical procedures. Retrieved October 11, 2007 from http://www.plasticsurgery.org/medical_professionals/publications/Physicians-Guide-to-Cosmetic-Surgery-Facial-Surgery.cfm.
Avram, M. (2005). Follicular unit transplantation for male and female pattern hair loss and restoring eyebrows. Ophthalmology Clinics of North America, 18 (2), 319-323.
Bernstein, R. M., & Rassman, W. R. (2005). Follicular unit transplantation: 2005. Dermatologic Clinics, 23 (3), 393-414.
BlueCross Blue Shield Association. Medical Policy Reference Manual. (3:2003). Reconstructive/Cosmetic Services. (10.01.09). Retrieved October 11, 2007 from BlueWeb. (0 articles and/or guidelines reviewed)
National Guideline Clearinghouse. (2004). Recommendations to diagnose and treat adult hair loss disorders or alopecia in primary care settings (non pregnant female and male adults). Retrieved October 11, 2007 from http://www.guidelines.gov.
Otberg, N., Finner, A. M., & Shapiro, J. (2007). Androgenetic alopecia. Endocrinology and Metabolism Clinics of North America, 36 (2), 379-398.
U. S. Food and Drug Administration. (2006, April). Center for Devices and Radiological Health. Sec. 895.101 Prosthetic hair fibers. Retrieved October 15, 2007 from http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=895&showFR=1&subpartNode=21:8.0.1.1.33.2.
U. S. Food and Drug Administration. (1997, April). FDA consumer magazine. Hair replacement: What works, what doesn't. Retrieved February 19, 2003 from http://www.fda.gov/fdac/features/1997/397_hair.html.
ORIGINAL EFFECTIVE DATE: 1/11/1983
MOST RECENT REVIEW DATE: 12/13/2007
ID_BT
Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.
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