Medical Necessity of Electrolysis/ Laser/ Permanent Hair Removal

Not only can most not fathom being born “wrong” but the repercussions of not being able to interact with others in the most social sense,if not the basest. Transsexualism now known as gender dysphoria, experienced to different degrees by those of biologic variance, not only forces the afflicted to overcome harsh social constructs equivalent to banishment from peers in our current society, for some of us it effects our ability to function, to ever develop physical relations. to “know” another human being on a relationship level.
Yet what i want to get through to you in this is something as common and unforgiving as HAIR.
If you accept the fact that brains are mosaicly sexed organs to infinit degrees, including instances of crossex adaptability, then one must include the complete nervous system as lending itself to what that brain perceives. in the epidermal system, the largest number of nerve endings are in bundles, around the root of each and every hair. A primitive form of extrasensory perception to most, unrelenting waves of dirty stitches sending signals of alienable wrong to others. A sexed brain would have evolved to expect certain structures based apon the sex hormones typically introduced directing expected growth at certain periods of a bodies development. the mental map of what the body should be is constantly under attack, what is termed “dysphoria” is in reality an utter revulsion from a form that seems to be attacking itself. “This isnt me,this is not self”. The central nervous unit is receiving signals from the genitalia and elsewhere, that somethings “wrong”, these should not be exposed and vulnerable but safely tucked inside. Now imagine those dirty stitches growing out of a woman’s face or out of her vagina that threw itself up thru virilization. The psychological/physiological torment of plucking-burning-razing only to have it return in ever thickening waves,the deformity betwix our legs that caused all of this ,also requiring permanent removal of hair in preoperative steps before surgical correction of the area can happen.
To the the afflicted this is not merely some life affirming aesthetic body work, this is a cruel constant untreated aggravation. Something that happened beyond our control, something that at one time was preventable through puberty suppressants now practiced on the youth, something that has a cure, held out of reach by ignorance.
Laser and electrolysis are both seen by the standards of care as being necessary and effective steps in combating crippling bodily dysphoria,which untreated causes sever depression,self surgical attempts, and suicide.
We cry to the heavens for help, please rethink blanketed exclusions of our minority’s necessary health care.

So ive been trying to become an electrologist in ohio for a number of yrs and have researched it to the extent i would call it purposeful and systemic barriers, enough to be able to explain the “job security” measures adopted by the electrology association and enforced by the DoH in columbus whose only reference to the field is the Association, DoH has no committee and relies solely on that Associations co chair who’s currently practicing charging 140 dollars an hr in the field.. the requirement of 150 hrs of head and neck massage that no electrolysis ever uses and that no school in the world requires outside of ohio. leaving 2 practicing electrologists as gatekeepers to who enters this entrely proprietary feild and when as they are small class sizes that open up when so many retire.

They also require you buy your way in to the feild at a tune of 17k out of pocket and they refuse to become accredited for fed loans , the DoH itself refuses talk to any other states schools or otherwise answer inquires. without that 150 hrs of “massage training” noone from other states can legally work here and no massage school does the training either. According to the DoH the Ohio restrictions on the feild went into place at least 15 yrs ago(turns out was an OAC code in 93), at which point in time all electrologists currently practicing were grandfathered in, so most practicing right now have never had the “training” now required. Its set up in such a way that there is only 1 or 2 electrologists in most smaller cities not surround a school, so as not to be competitive with pricing or technique. the DoH also refuses to answer any calls or emails from other state schools when they try to find out how to get accredited with ohio; meaning i cant go to Massachusetts an use student loans to learn an be licensed to work in ohio (though mass has the best and even more stringent requirements, itd let me practice anywhere in the world, and one of only 2 schools in the US i can use federal loans for, but i couldn’t afford to move there and it wouldn’t let me work here fixing this one aspect of society here in leelahs graveyard.

So of those electrologists in ohio, half wont even work on a trans person, of the half that do some prefer we come in “after hrs”, and most refuse to do preop work for surgery. Of those that do treat us they are using flash thermolysis which of the 3 techniques available (thermo/blend/galvanic) has the highest regrowth rate. Trust is paramount when talking about an estimated 65 an hr at an est 100-400 hrs to clear a face, let alone “down there”. Its an insurmountable cost to a minority known as THE health disparity population. noone is seeing us as projects to be done.

bought an older thermolysis machine from ebay (what youd see most grandfathered electrologists use) but weary of using it myself without training,spose i got to start somehwere but i know ill scare myself learning insertations. have been reading the go to manual up till 84′ called Electroloysis, Thermolysis, and the Blend, by Hinkle and have had talks with a handfull of licensed electros in diff states, so have a good understanding of theory and concepts of ethical practice.

spent all 2016 accumulated and learned to write medical necessity letters  built off PCOS templets.;of which i have one from primary care, dermatologist, psychiatrist, and ENT. First of the yr the affordable care act guidance went into play meaning contractually all medicaid must remove exclusions against transgender care. i now have  50 hrs of electrolosis for face and genital “no prior auth required” under ohio medicaid, that’s never happened before for anyone. Nor yet as a yr into this and i cant find an electro to become an “out of network provider”. caresource is currently dodging it “sure well cover it good luck turning on an industry that’s historically been considered aesthetic and not setup to bill us,HAHAHA.” left to beg to be reimbursed for out of pocket costs. im now 600 of my 1000 goal to take them to small claims as soon as they try to deny the reimbursement.

im also trying thru the bureau of vocational rehabilitation on a longshot to partially pay my way thru school as that’s the only hope a marginalized minority without human rights has here. “if i can help another i can help myself” kind thinking. I want to work with the indigent, sliding scales, insurance, partner with UC or some other health network or trans org who could go after funding an grants to offset the cost to do the most marginalized trans women for free. i need to insert myself inside this healthcare machine to make one of the 4 modalities of care actually available to us. (if this is possible its not thru warren county)

this is what i got goin on so far, bought an older machine off ebay came with all sortsa extras but still not confident enough to try zappn myself, yet.

electrolysis- the permanent removal of hair. must be done to the entire genital region before surgery, conservative timing, that is if i can go to electrology once a week for an hr, sets me back a yr before i can even schedule. they say a yr because hair grows back in stages sometimes weaker meaning having to treat a follicle multiple times, and then new growth from dormant pores also needs to be rid of “having sex with hair growing from the inside of your vagina will not be cocomfortable in the least”. so im almost back to hopelessness, as i cannot afford weekly treatments of electrolysis needed to make that timeline. i cant even rid my face of these dirty stitches, let alone start and finish in an “unnoticeable” area.though it plagues me an i can feel anagen growth weeks before any visible hair thru yrs of plucking the area which has only made the hairs thicker and deeper. the cheapest electrolysis i can find is 32.50 a 1/2hr/65 an hr, thats impossible to pay somone a dollar a minute when i dont even make a dollar an hr. i dunno, im about to start doing my on medical procedures meaning electrolysis , with no teacher or mentorship. as that seems to be my only option.

school for electrology

its like they’ve created this wall where they grandfathered any practicing electrologist’s while making sure there would be no newcomers. a form of job security where they can name their price, without ever having undergone the training they now require, where 2-3 practicing eletrologists are gatekeepers of who gets to practice In ohio, making sure that noone poor  enters  the field by refusing federal school loans to do so, requiring us to buy into the field at an insurmountable price, while allowing them to set rates on treatment without having to be competitive in pricing, equipment or technique.

from a school not in ohio-

“Ohio has a 750 hour electrology training requirement and at the present time, American Institute of Education does not support or offer this curriculum. Ohio is one of only a few states that requires out of state vocational schools to become “state approved” with Ohio’s State Medical Board and the Directors of AIE decided that there wasn’t sufficient reason to pursue this requirement. We also disagree with their curriculum to some extent. The curriculum requires 150 hours of head and neck massage training, something that no other state requires and that no electrologist would consider doing. If you plan to practice electrology in Ohio upon completing your training, we suggest that you attend a school in this state.

If you live on the border of a neighboring state and plan to work there rather than in Ohio, or, if you are planning to move from Ohio to another part of our country, call our Director, Ron Davis at 888-844-4247. AIE trains students for most other states in our nation and we would be pleased to assist you.”

they do have a scholarship towards going to their school. should apply even if it wont help me in ohio. they do have something they call a walking degree that is basic education for the 16 or so states that dont require licensure.

so that school in california replyed saying i should just do school in ohio without giving much to go on  but to look here in the (which im emailing a rep in ohio from the contact us page)  inquired again with the cali person an they got me a link to a new school opening in columbus on a hairtell forum —–

contacted the area educational chair and they gave me links to the one in cbus

Mary Kaye Johnson

“Your message was forwarded to me regarding the electrology training programs in Ohio.  The American Electrology Association is not a regulatory body so the information provided is simply a list of the known schools in Ohio.  You should call both schools with your list of questions and go from there.  That said, please feel free to call me with any general questions regarding training.  The AEA website at has information regarding the CPE designation.  If you click on the Professionals page, there is a link on the left hand side of that page with info on becoming a CPE along with the CPE test bulletin.  Wherever you train, you should plan to take the exam and become a member of the AEA in order to stay on top of continuing education opportunities and be involved with the wonderful peer networking opportunities.”

Here is the contact information I have for the 3 schools that can train for ohio:

About Face Cosmetic Therapy

Vickie Mickey

1918 Bethel Road

Columbus, Ohio 43220

By Phone: 614-457-0448

By E-Mail:

they want 16-17,000 and that liscences me as an asthetic therapist(?no idea theres a diffrence between electrologist and therapist?)


as well the one in mansfeild

Ohio Medical Electrology Institute

attn. Jo Melching

271 Cline Ave. Suite # 4

Mansfield, Ohio 44907



or visit:


one in ky (also 2 hrs away) does have 3 diffrent levels of courses, i could do 350 hrs that wouldnt liscense me in oh but it would eleswhere but nowhere i wanna go. would give me a better understanding of what im doing to myself.

350 HOURS:       $5100.00

600 HOURS:       $6800.00

765 HOURS:       $9100.00

Laser Hair Removal Courses: We also offer Laser Training courses which can be completed in one week or less.

30 HOURS:        $2600.00 (Three day course)

50 HOURS:        $3500.00 (Five day course, one week from Monday-Friday)

+the cost of machine n books 😦 machine being 4 grand


so far the only school in America that takes federal school loans is in salt lake city utah

sent timid interest thigy waitn to hear back 🙂 no hear back 😦 and hear it uses you as free labor without teaching theory

I sent another email and didn’t mention anything about ohio,got a reply…

Good Morning Jayla.

This is Cyndle with Cameo College Admissions. Thank You for your inquiry. The Electrolysis industry is a fantastic industry to get into 🙂 I can definitely help you w/ your FAFSA, have you ever filled out one before?

I would suggest coming into Cameo College. When you come I will give you a tour of the campus, go over course curriculum, and tuition. I will also help you fill out your FAFSA at that time 🙂 I am available Tues – Sat is there a day of the week that works best for you?

“You can never be overdressed or overeducated.” ― Oscar Wilde

Cyndle Mendoza

Cameo College Admissions Advisor

801-747-5705 Direct Line

801-747-5701 Fax

the hatefull Mormon social culture of Utah 😦 mentioned because that’s where cameo college is

Whoot! Found a school that takes fed loans in massachusettes! Electrology Institute of New England , and guess what?  Omg  they refuse to let me in!? this is there reply,caps an all



Bureau of Vocational Rehabilitation, every state has one, theres an offchance that they might at least partially pay my way thru school, they gota cause it only hope 😦 anyhoo so i meet with my caseworker, she seems ok but sorta defeatist, maybe thats just the devils advocate telln me what i need to hear. we are going to develop a business plan and present it to columbus in hopes of approval. she says we need statistical evidence of jobs and industry placement for what im trying to do….3 months later and she still hadnt got back with me so i filled greivance and she could meet next day where she used a half hr befor hand to dismiss the need for a trans competant electrologist using a job scale even when told its self i filed greivance higher, who sent me higher to the director who immediately found the schools the worker had said she couldnt find and gave me a list of things ill need to accomplish if i can access the BVR thru a better county apparently.

so found this ISBS seems to be some business savy statistical thingy 🙂 i wonder where i find access to getting the full readout?

Hair & Nail Salons in the US: Market Research Report

IBISWorld identifies 250 Key Success Factors for a business.The most important for the Hair & Nail Salons Industry are
Business expertise of operators (i have good work ethic)
Having a loyal customer base (i would be the go to girl electro )
Access to niche markets (which i would dominate)

Hair Loss Treatment & Removal in the US: Market Research Report

Over the five years to 2016, industry revenue is expected to grow due in part to the rising emphasis consumers have placed on physical appearance. Aging males seeking hair loss treatment and females seeking hair removal services dominate industry demand. Over the five years to 2021, revenue for the Hair Loss Treatment and Removal industry is projected to grow at a slightly more subdued rate

Plastic Surgeons: Market Research Report

Interest in cosmetic surgery continues to climb as technological advancements make procedures more accessible, more affordable and safer. Cosmetic surgery is no longer reserved for the wealthy or famous; most cities in the United States are home to plastic surgery centers, offering body contouring procedures, such as liposuction and breast augmentation; facial rejuvenation, such as eyelid surgery and chin and cheek implants; laser hair removal; and other enhancement procedures.

IBISWorld identifies 250 Key Success Factors for a business.The most important for the Plastic Surgeons Industry are

  • Educating the wider community (most of the market is geared towards cisgender)
  • Adopting new technology (afflicted i understand pain management and the value of various techniques)
  • Easy access for clients (i create a direct route to access care)

here’s a nice one with multiple different stat sources for the field of plastic surgery

Surgeons report nearly 20 percent increase in number of transgender surgeries

^ a talk with dr ting from mount siania in new york whos pioneering advancements in GRS, talks to the need and lack of surgeons available, started first fellowship, for first time in 2017 theres a place for surgons to train. the feild is more open, more sharing of techniques n procedures.



grants and funding for inclusive resources
trans ohio-symposium, i think this is wher you would present your ideas in hopes of finding funding for your LGBTQIA non profit or business?
trans justice funding project
mellinial fund
apalachian regional commision

native grant, I have native blood,my greatgreatgrandma but my current grandma says “they liked to dress like Indians” as dig to me an refused to meet me to discuss the geneology she built. If I can prove that it opens me up to grants for school and other benefits might have to do a DNA test

nice compilation of scholarships for LGBT people!
trans studies scholarships an fellowships
2,000 feminist writers
disability vocational training might find a grant for electrolysis school ?every state has it
AOTC tax credit for first 4 yrs of school, 2,500 per yr of documented expenses
IRS school first 4 yrs 2,500 deductable
Duane Gordon, Middletown community foundation
Our rules don’t allow me to pass around any requests to people but we might be able to help. Twice a year we take applications for nontraditional students (meaning people age 25 or older going back to school). I’m not sure which of our funds are open for trade-School type classes like this or which ones are restricted to more standard associates and bachelors degrees in college, but you might qualify to be considered for those scholarships. Can’t guarantee you’ll get anything, but if you don’t fill out the application and try, you’ll never know! The application becomes available online June 1 at The typical award is between $500 and $2,000 per semester. You have a to reapply each semester. The application is due July 1 for fall semester and December 1 for spring semester.


Friend tried to help me address the systemic issues… but never heard back.

sirenandsailor (Aaron)
Good morning Jim,
Sent this to Representative Butler this morning:

Had an individual pose a question to me that I believe you might be able to help find answer. OAC 4731-1-07 requires that to become a licensed electrologist in Ohio you must attend a school based in Ohio, surround State’s licensures are not acceptable. The catch with this restriction is that NO SCHOOL currently exist in Ohio from which to obtain training. Ohio Means Jobs show 1380 currently employed electrologist with an expected growth of 30 for the year. How is this obtainable when there is NO training pathway? Follow on question would be WHO benefited when restriction was put into place? Excerpt from OAC 4731-1-07 is included below.
Thank you kindly and anticipate your response.

4731-1-07 Eligibility of electrologists licensed by the Ohio state board of cosmetology to obtain licensure as cosmetic therapists pursuant to Chapter 4731. of the Revised Code and subsequent limitations. -A person who was issued a cosmetic therapist’s license prior to February 1, 1993 based upon holding a certificate to practice electrolysis and registration issued under Chapter 4713. of the Revised Code, may be registered by the board as a cosmetic therapist but may not apply “systematic friction, stroking, slapping, and kneading or tapping of the face, neck, scalp, or shoulders” as defined in division (A)(2) of section 4731.15 of the Revised Code until that person has completed coursework in that area that has been approved by the board at a school approved by the board pursuant to this chapter of the Administrative Code


Also sent to Representative Strahorn (Minority Leader) and Representative Rosenburger (Speaker of the House)


Hello Kitty, (see what I did there)

Thank you for the email. I reached out to a contact I have at the Medical Board to see if he could possibly shed some light on the situation and provide some answers. I just emailed him a few minutes ago, so I haven’t heard back yet, but I will share his response with you when I receive it. Thanks again for writing, and hopefully we can get a good answer…
Best Regards,

Jeff Dillon

Legislative Aide
State Representative Jim Butler, 41st District
77 S. High Street. 13th Floor / Columbus, OH 43215
Office: 614-644-6008
Fax: 614-719-3591


-a talk with anouther elctrolosis,shes in tennessee

a study done using my machine !! ss-69 epilator, the article uses disgusting terminology being from 97 (the 90s weren’t kind) in general stresses the need for a good electrolysis whos successfully treated trans women befor and how done wrong can be no reduction :/

they do a “modern elctrolosis symposium” in Quebec Canada, this is 2015’s. Dectro International hosts it every year. They produce the Apilus machines

Johanne Fortier CPE, LE, National Training Director, Laura Bomar (from tenn)trained with her in California and she trains students for unlicensed states. She runs a business called Aesthetics Systems and works mostly with Dectro products.

get a daylight lamp,some cheap ones at joane called Ott lite or verilux which is what laura has

Prestige, is an electrolosis supply store sells things like magni specs

texas electrolysis supply, is another supplier of everything, both sell needles an whatever

sterilizer is required by the CDC, A Dry Heat sterilizer by Wayne or an Autoclave steam machine, a pricey item 500 or so

she has the Oakworks Wellspring Portable Massage Table. It is made so that legs can fit underneath it. Most massage tables don’t allow for that, so make sure your legs can fit under whatever table you decide on.

you’ll need a pump bottle for the alcohol and many people use witch hazel for after care use.

“takes about 3 to 5 thousand to get started right in this business.” Laura bomar (thanks 🙂

“There are some probe companies that will send free samples. she uses Sterex probes, but there are different brands and everyone has their favorites got some free samples of probes from Pro Tec last year.”

“sterilizing the instruments like tweezers though. You’ll have to have the proper sterilization before working on anyone. That’s for your safety. You will also want to be certain to get Hep shots and other shots/vaccinations required for healthcare workers.”

“Laurier probes are the best in quality and they are also the most expensive. The spend a bit more time developing these probes and may have some detailed information that will help. Electrologist who use these probes often charge a bit extra to cover the cost. I use Laurier for the galvanic and Sterex for thermolysis. But, everyone is different. It’s a bit overwhelming”

“I would charge more for bikini area than face, because it’s more difficult and harder on your back to manipulate the area around the bikini. Watch your posture, too! That’s a big issue with electrologists….big issues. Go to any length to keep your posture as good as possible – it will save your back, neck and many types of health side affects. Posture is something I have to work on. I got this great gadget that I positively love… “


electrolysis / laser, a further education

pg 128, depilatories, creams and paste for hair removal, dicks encyclopedia of practiclal receipts and processes, or how they did it in the 1870’s

electrolosis works! blog by an elder technician

how to code and treat for insurance

how long will electrolosis take?  Est 200hrs but can be from 1-400

Why Getting a Haircut Can Be a Traumatizing Experience for Transgender People

for those undergoing SRS/GRS/GCS this is a drawing from the Michigan Gender Clinic on what areas need to be free of any dirty stitches befor surgery can happen.copy paste if it doesnt show up as a link.


^ if that link doesnt work it can also be found in the group i made on FB, DIY hair removal

Re.You Studio is where cassey is gettn laser done

“how to get laser covered by insurance”

  1. I went to a dermatologist
    2. Procedure Code Identity: 17999(I found this
    3. Description of Service: laser hair removal
    4. Diagnosis Code: 626.9 (PCOS code)!

Vaniqua, a cream for reducing the speed of hair growth, 70 bucks, wanna try it after readn . this also is a great place to know your not alone with your hair issues even though it PCOS ladys knowing cis women get it to somehow helps?

A precedent has already been set indicating that depilatory treatments are “medical care” for insurance purposes (Abernathy v. The Prudential Insurance Company of America, No. 21178, Supreme Court of South Carolina, March 31, 1980). In this case Plaintiff brought suit against her insurer after it refused to reimburse her for the cost of depilatory treatments (i.e. electrolysis) which had been recommended by her physician. The policy included as “eligible expense” charges for “doctors’ services for surgical procedures and other medical care”, and contained a provision excluding “anything not ordered by a doctor or not necessary for medical care of illness”. The South Carolina State Supreme Court affirmed a verdict for the plaintiff, noting that there is no requirement that “medical care … be performed by or under the direction of licensed medical personnel”. Further, the court held, since plaintiff underwent treatments pursuant to her physician’s advice, such expenses were medically “necessary and were not excluded from coverage under the policy”.

Again, if your health care provider has covered any part of your treatment that has anything to do with why your hair removal in needed, you have a good chance to beat the money out of them in small claims court.

SFHP will cover electrolysis and laser hair removal for the following surgeries

  1. Vaginoplasty (genital area and face)
  2. Metoidioplasty (exclusively to the genital area)
  3. Phalloplasty (genital area and graft site)

^ As of February 20, 2015 San Francisco Health Plan amended

their guidelines to include limited coverage for facial hair

removal for transgender patients who meet medical

necessity. SFHP thus far has indicated that they will only

approve facial hair removal for patients who also have a

Prior Authorization approved for vaginoplasty.

While it is clear that the medical necessity for facial hair

removal should be considered separately from surgical

status and that these procedures should be authorized

independently, SFHP is currently not interpreting coverage

this way.

Expanded coverage for medically necessary gender-related

procedures has often been gained through winning

coverage for individual patient cases. This is typically a

lengthy process that requires a series of denials and strong

provider advocacy documenting medical necessity.

For patients who have an approval for vaginoplasty with

SFHP, facial hair removal is more likely to be approved,

however SFHP could still deny requests on a case by case


This guide provides an overview of how to make a referral

for facial hair removal, how to fill out Prior Authorization

forms, what clinical documents to attach to them, and how

to appeal a denial.

NY state covers electrolosis as preoperative for vaginoplasty and metoplasty

what do you think about coding it under “intensive outpatient therapy for the treatment of GID” ?theres gota be a way…


Next…. AFTER you get a prescription reimbursed by the insurance Co. you file for reimbursement of electrolysis treatments. They will still maintain hair removal is cosmetic, however, too much hair in all the wrong places is a medical problem and if needed visit asecond doctor to get a second opinion as they have to pay for this too. You will have to appeal their decision and you have 3 appeals to go through. At the third appeal you challenge them. NEVER SURRENDER THE POWER. MAKE THEM KNOW YOU ARE NOT TAKING ANY NONSENSE and you will beat them in court because of �industry precedent�. They have a contract to pay for all diagnosable and treatable diseases and electrolysis is the �current standard of medical treatment for this condition� (remember this phrase…it is vital to your argument).  *Has a sample letter to insurance as well*



RE: (patient�s name) Policy No. #000000

Dear Ms./Mr……………

I have prescribed for my patient, Ms. ………….., electrolysis
(procedure 17380) as a consequence of a hormonal imbalance resulting in
hirsutism (excessive and abnormal growth of hair in a distribution not
normal in a female… (diagnosis 704.1).

I am writing you to clarify the medical necessity of this treatment.
Hair removal is NOT cosmetic in these patients because

A. a medical condition causes the hair growth.
B. permanent removal of hair is necessary to restore the patient to normal function.
C. the physician can measure the effectiveness of medication by
monitoring the presence or absence of  new hair growth in the areas involved only after
electrolysis therapy. Since no two patients respond  in a similar manner to a given dose of any medication, dosage MUST be individualized to minimize potential �side effects�. Electrolysis, therefore, is instrumental in establishing the most effective dose of medication, consequently, the electrolysis procedure is diagnostic as well as  therapeutic.
D. To achieve maximum benefits for the patient with Hirsutism it
is necessary to include electrolysis of  the follicle concomitantly with medical therapy or else the
patient is denied the benefit of the current body of medical knowledge regarding treatment of her condition. Also, it is unethical for a physician to  withhold any information from a patient that the physician knows to be effective.
E. Electrolysis is standard, current medical practice and is the
only permanent treatment for hirsutism in this medical condition and has been certified as medically indicated and necessary by a disinterested  physician, Dr. …… , a Board Certified Endocrinologist (or Gynecologist).
F. There is industry precedent in Massachusetts and a number of states for coverage of this procedure.

Please contact me if I can be of further assistance

Yours truly

Very important phrases…………

1. A hormonal imbalance resulting in hirsutism (excessive and abnormal
hair growth not normal in a female 2. Is NOT COSMETIC in these
patients. 3. A medical condition causes the hair growth. 4. Permanent
removal is necessary to restore the patient to normal function. 5. the
physician can measure the effectiveness of medication by monitoring the
presence or absence of new hair growth ONLY AFTER electrolysis therapy.
6. no two patients respond in a similar manner to a given dose of any
medication.� 7. dosage MUST be individualized to minimize potential
side effects. 8. Electrolysis, therefore, is instrumental in
establishing the most effective dose of medication. 9. the electrolysis
procedure is diagnostic as well as therapeutic (this is vital because
To achieve maximum benefits for the patient it is necessary to include
electrolysis. 11. or else the patient is denied the benefit of the
current body of medical knowledge regarding treatment 12. It is
unethical for the physician to withhold any information from a patient
that the physician knows to be effective. 13. Electrolysis is current
standard medical practice. 14. the only treatment for hirsutism in this
medical condition. 15. has been certified as medically necessary by a
disinterested physician (this means the physician has no vested
interest in electrology other than to see the patient get the most
effective treatment with no financial gain for the physician). 16.
there is industry precedent for coverage for this procedure (in law
they often resort to �precedent� so this VIP). In addition, read the
policy to see if there is any wording that refers to �diagnosable and
treatable disorders� which this is as opposed to a �cosmetic
procedure�. Electrolysis for cosmetic purposes would be limited to
eyebrows, underarms, bikini line, raising the hairline on the forehead.
All other areas could be part of a medical problem.

Do not let them push you around. Their tactics usually involve denying
and delaying all these claims. Send all correspondence by �return
receipt requested mail� so you will have proof the letter was sent and
received. Sometimes they claim they �lost� the letter but if you get no
reply send another with a note there will be more and it is doubtful if
they lose all correspondence. Lastly you can take them to small claims
court after about only $1000 of treatments. Ins companies do not want
to go to court under any circumstance as they know nobody likes them
and the penalties are usually severe. They will try to call your bluff
every time as the know no lawyer will take a case for less than $50,000
so they figure you will drop the whole thing due to frustration.

Electrology and the Hirsute Polycystic Ovary Syndrome Patient,remember if it is covered for one gender it must be covered for the other!  if they would approve it for a bearded woman due to PCOS or something similar, that along with a state’s (or the federal marketplace)nondiscrimination policy should be sufficient grounds for getting it approved.

hypertrichosis is the term used to denote excessive and abnormal growth of hair, on any part of the body which is more than is seen in individuals of the same sex, age, and race as the person under consideration. Genetic, androgen-independent excessive hair growth

Hirsutism is defined as the presence of terminal hairs on women in a male-like pattern and often is a sign of underlying androgen excess (hyperandrogenism) Mechanical treatments
Therapy for the patient with unwanted hair growth would not be complete without treatment to remove existing hair growth (Table 3). A number of methods have been reported to reduce unwanted terminal hair growth, including electrology and laser hair reduction. Electrology has been available for decades, and although prospective randomized trials are few, extensive clinical experience appears to indicate that it does afford permanent hair reduction in most patients. Laser hair reduction is a much newer modality, and although it does appear to offer less-permanent hair removal than electrology it provides significant hair reduction. Nonetheless, these methods do have their drawbacks. Electrology requires multiple and frequent treatment sessions that can be painful, depending on the location and extent of hair involvement. Likewise, laser hair removal has the potential for causing skin damage and is primarily effective in those patients who have dark hairs and lighter skin. Both of these methods can be quite cost ly in the long run. As such, the recent advent of newer topical therapies for reducing hair growth is of importance.

More than 14 million women complain of unwanted facial hair growth, approximately one fourth of whom actually suffer from hirsutism. Evaluation of these patients should include a determination of whether they actually have hirsutism and have concomitant endocrine or metabolic abnormalities. The appropriate treatment for a woman who has unwanted hair growth may include hormonal therapy, but should also include mechanical and/or cosmetic means of removing hair growth. The newly approved eflomithine HCl cream, 13.9% is a useful adjuvant in reducing noticeable hair growth in affected women.

current treatment of hypertricosis, NCBI, electrolysis

Facial hypertrichosis and hirsutism may cause severe cosmetic and psychologic problems. In the following, new developments in the treatment of hypertrichosis will be presented. Permanent depilation by photothermolysis is currently the most promising treatment. A new topical treatment of hypertrichosis is eflornithine cream. It inhibits the enzyme ornithine decarboxylase which is essential for the rapidly dividing cells of the hair follicle. Furthermore, other methods of hair removal such as plucking, waxing, chemical depilation by thioglycolates, electrolysis, thermolysis and systemic therapies of hirsutism will be discussed.

Guidance for the management of hirsutism. NCBI,

Approximately 80% of women are affected by the presence of excessive hair growth in a ‘male-like’ pattern. Excessive facial hair in particular can be a source of distress to such women and can lead to psychological problems such as anxiety, depression and a reduced quality of life.Current cosmetic methods of hair removal include shaving, depilatories, waxing, plucking, laser, intense pulsed light (IPL) and electrolysis.A topical treatment cream such as eflornithine 11.5% can slow hair growth and thus reduce the frequency of the need for hair removal. This treatment can be used effectively in conjunction with hair removal methods.

Comprehensive clinical management of hirsutism, NCBI

Hirsutism is an excessive body and facial hair growth in women in locations where is normally minimal or absent following a hair-male pattern. For this reason is not uncommon that hirsutism raises psychological, cosmetic and social concerns. There are many treatment modalities that can be summarised into two broad groups: pharmacologic and non-pharmacologic treatment. Until now, medical treatment has been designed to interfere with the synthesis of androgen at the ovarian or adrenal level, or inhibit the effect of androgen at the receptor level, although recent progresses test other options such as insulin modulators or ornithine decarboxylase inhibitors. Mechanical treatment includes laser hair removal, electrolysis, depilatory creams, plucking and waxing. This article presents a general overview of hirsutism treatment options.

‘L689’ (L68.9) Diagnosis – Hypertrichosis, unspecified

The code is valid for submission on a UB04

L68.2 Localized hypertrichosis

is a billable medical code that can be used to specify a diagnosis on a reimbursement claim.

But the blurbs say that if you use a “”99” code the insurance will want the DR to justify the medical need. (Although there is a clear medical need as removing a beard for a woman is not just cosmetic.) The Dr’s office told me that they don’t know of a code! So I am sure that if they did not wish to look up a code, they will not wish to print a letter of medical necessity to justify insurance payments. I was, therefore, looking fo a non-general/non-99 code.

-question concerning laser ^

ICD-9-CM 704.9 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 704.9 should only be used for claims with a date of service on or before September 30, 2015. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM code (or codes)


if anything was useful, or ya’ care, here’s my fundy meh’ to go to school


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