March 20, 2025
Educational Article: Scalp Cooling for the Treatment of Chemotherapy-Induced Alopecia
Mechanical scalp cooling has been demonstrated to reduce chemotherapy-induced alopecia for breast, ovarian, fallopian tube, and peritoneal cancer patients who are being treated with cytotoxic chemotherapy regimens that have alopecia as a common side effect. This article provides instructions to provides on how to code these services. Coverage for scalp cooling is established by NCD 110.6 Scalp Hypothermia During Chemotherapy to Prevent Hair Loss: NCD - Scalp Hypothermia During Chemotherapy to Prevent Hair Loss (110.6).
This service is represented by the Category III codes:
0662T – Scalp cooling, mechanical; initial measurement and calibration of cap.
0663T – Scalp cooling, mechanical; placement of device, monitoring, and removal of device (List separately in addition to code for primary procedure).
Billing instructions:
For Hospital Outpatient department and inpatient claims:
Hospital Outpatient Prospective Payment System (OPPS) claims (S status):
0662T is priced by CMS. This is billed once per course of chemotherapy. Therefore, if a course of chemotherapy involves 6 or 18 sessions it is only reported once.
0663T is N status under OPPS which means it is bundled and not eligible for separate payment.
For Part B:
The cap is a supply and not eligible for separate payment.
0662T is billed once per course of chemotherapy for the initial measurement and calibration of the cap.
0663T is billed for each session of chemotherapy through the course of chemotherapy in which the service is provided.
The need to use scalp cooling for more than 8 sessions may be subject to medical review as most chemotherapeutic courses are 8 or fewer sessions.
ICD-10 codes:
For all sessions the most specific ICD-10 code indicating active chemotherapy for breast, ovarian, fallopian tube, or peritoneal cancer being treated with an alopecia inducing agents should be utilized.