BlueCross BlueShield of Tennessee Medical Policy Manual

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

IMPORTANT REMINDERS

ADDITIONAL INFORMATION

The Code of Federal Regulations (Title 21 – Food and Drugs, Subchapter H – Medical Devices Part 895 Banned Devices, Sec. 895.101 Prosthetic hair fibers):

Prosthetic hair fibers are devices intended for implantation into the human scalp to simulate natural hair or conceal baldness. Prosthetic hair fibers may consist of various materials; for example, synthetic fibers, such as modacrylic, polyacrylic, and polyester; and natural fibers, such as processed human hair. Excluded from the banned device are natural hair transplants, in which a person's hair and its surrounding tissue are surgically removed from one location on the person's scalp and then grafted onto another area of the person's scalp.

SOURCES

Code of Federal Regulations (1983, June) Title 21 – Food and Drugs, Subchapter H – Medical Devices Part 895 Banned Devices, Sec. 895.101 Prosthetic hair fibers. Retrieved March 3, 2017 from: http://www.ecfr.gov.

Feily, A. & Moeineddin, F. (2015). Feily’s method as new mode of hair grafting in prevention of scalp necrosis even in dense hair transplantation. Dermatology Practical & Conceptual, 5 (3), 41-46. (Level 4 evidence)

Mansur, A. T., Demirci, G. T., Uzunismail, M. A., & Yildiz, S. (2016). A rare complication of follicular hair unit extraction: Kaposi’s varicelliform eruption. Dermatology Practical & Conceptual, 6 (1), 15-17. (Level 4 evidence)

Otberg, N., Finner, A. M., & Shapiro, J. (2007). Androgenetic alopecia. Endocrinology and Metabolism Clinics of North America: 36 (2), 379-398. (Level 5 evidence)

Wisconsin Physician Service Insurance Corp. (2017, January) Local Coverage Determination (LCD) Cosmetic and reconstructive surgery (L34698). Retrieved March 3, 2017 from: https://www.cms.gov.

ORIGINAL EFFECTIVE DATE:  11/1983

MOST RECENT REVIEW DATE:  4/13/2017   

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.

This document has been classified as public information.