By Pamela Shaddock & Dianne Austin | Co-Founders, Coils to Locs
Here's something most women navigating medical hair loss don't find out until way too late, or sometimes never at all.
The wig you need? It may already be covered by your health insurance.
Not as a fashion accessory. Not as a luxury. As a cranial prosthesis, a medically necessary device, and there are specific medical billing codes that exist to support the healthcare reimbursement of a cranial prosthesis.
We're Pamela and Dianne — sisters and co-founders of Coils to Locs. When Dianne was diagnosed with breast cancer in 2015, her insurance covered her treatment and she had a supportive employer. But as we started building this company and talking to many women going through what Dianne went through, we kept seeing a pattern: women who needed a quality wig, had insurance that should have covered it, and had no idea that was a thing or how to make that coverage potentially happen.
Some of them didn't even try and missed out. Some of them paid out of pocket for wigs that didn't reflect their natural texture. Some of them just went without.
That's not okay. And it's one of the reasons we built this company.
This post is our answer to that gap. We're breaking down what you need to know, what to say, and what to do to hopefully file a successful insurance claim for your wig. And we've put everything in a free one-page cheat sheet you can download and take with you to every call and every appointment.
First, Let's Talk About Why Most Women Don't Even Try
The insurance system was not designed with us in mind. Period.
Black women experiencing medical hair loss, from chemotherapy, alopecia areata, traction alopecia, trichotillomania, or any number of other conditions, face a specific kind of exhaustion that goes beyond the physical. You're already managing a diagnosis. You're already navigating a medical system that has historically underserved women who look like us. And now someone is telling you that you have to advocate for yourself through a complicated reimbursement process just to get a wig that actually matches your hair texture.
Most women hear the word "insurance" and assume the answer is no before they've even asked the question. Who can relate?
We're here to tell you: ask the question. Ask it with the right words and the right documentation, and more often than you might expect, the answer can be yes.
The One Word That Changes Everything: Cranial Prosthesis
This is the most important thing in this entire post, so we're putting it right here.
Do not call it a wig when you talk to your insurance company. Call it a cranial prosthesis.
A cranial prosthesis is the medically recognized term for a hairpiece prescribed to replace hair lost due to a medical condition. "Wig" gets filed under personal care. "Cranial prosthesis" gets filed under durable medical equipment. That one word can be the difference between a covered claim and a denied one.
Write it down. Put it in your phone. Say it when you call your insurance company. Make sure your doctor uses it when they write your prescription — and make sure your itemized receipt uses it too, not the word "wig."
The Two Kinds of Codes Your Claim Needs
Here's the part that trips people up, so let's make it simple.
Every insurance claim for a cranial prosthesis actually needs two different codes working together, because they answer two different questions:
- What did you buy? That's the billing code.
- Why do you medically need it? That's the diagnosis code.
Your insurer needs both. The billing code alone looks like a purchase with no medical reason behind it. The diagnosis code alone doesn't tell them what to reimburse you for. Together, they turn "I bought a wig" into "I have a documented medical need for this cranial prosthesis, here's the product, please reimburse me."
(As always: confirm the exact codes with your doctor's office or your insurer before submitting — codes and coverage rules can vary by plan.)
1. The Billing Code (HCPCS Code)
This tells your insurer what product you purchased.
- A9282 — the standard billing code, officially listed as "Wig, any type, each." This is the one most plans use for a cranial prosthesis, even though the code's official name still says “wig."
- S8095 — an alternate code some insurers use instead, listed as "Wig for medically-induced or congenital hair loss.”
Because insurers differ on which one they accept, it's worth asking your Member Services rep directly which code they want on your claim. Either way, your prescription and itemized receipt should still say "cranial prosthesis," not "wig" — that's the language that gets it filed as durable medical equipment rather than a cosmetic purchase.
2. The Diagnosis Code (ICD-10 Code)
This tells your insurer why you need it — without it, a claim can get denied as cosmetic rather than medical.
- L65.9 — non-scarring hair loss, unspecified. Covers most chemo-induced and general hair loss.
- L63.9 — alopecia areata, unspecified.
- L63.0 — alopecia totalis (complete scalp hair loss).
- L66.1 — lichen planopilaris, a form of scarring alopecia
- Z51.11 — encounter for antineoplastic chemotherapy. If chemo is the cause of your hair loss, your doctor may add this alongside your hair-loss code (like L65.9) to show the hair loss is tied to active cancer treatment.
Keep whichever codes apply to you saved in your phone. You'll need them on your claim form, and having them on hand during phone calls signals to insurance representatives that you know what you're talking about, which matters more than it should, but there it is. As a general rule always ask "is there anything else I need to add?" when you're closing out your conversations.
Important note: always verify the specific codes that apply to your diagnosis with your doctor or a medical billing professional before submitting a claim. Your doctor's office may use slightly different codes based on your specific condition, and coverage of any given code varies by plan.
Your Step-by-Step Claim Walkthrough
Step 1: Call Your Insurance Company Before You Buy Anything
Call the Member Services number on the back of your insurance card and ask directly: "Does my plan cover cranial prostheses or wigs for medical hair loss?" While you have them on the phone, ask which billing code they want (A9282 or S8095), your deductible, any co-pay, annual coverage limits, and whether you need pre-authorization. Get the name of the representative and a reference number for the call. Write it all down.
Step 2: Get a Prescription From Your Doctor
Ask your oncologist, dermatologist, or primary care physician for a written prescription for a cranial prosthesis. The prescription needs to:
- Say "cranial prosthesis" — not "wig"
- Include your diagnosis code(s) and the medical reason for hair loss
- Be on official letterhead and signed by the prescribing physician
Keep the original. Only send copies to your insurer.
Step 3: Purchase and Get Your Itemized Receipt
When you purchase from Coils to Locs for example, request an itemized receipt that says "cranial prosthesis" and includes the billing and any other code, product description, and price. This is the documentation your insurer will need.
Step 4: Complete and Submit Your Claim
Download your insurer's claim form from their website, or request one by phone. Fill it out using both your billing code and your diagnosis code from above. Attach your prescription, itemized receipt, and a copy of your insurance card. Submit by certified mail or through your insurer's secure online portal, and keep copies of everything.
If you don't hear back within two to three weeks, follow up. Persistence is part of this process.
What To Do If You're Denied
A denial is not necessarily a final answer. Here's how to respond:
- Request a written denial with the specific reason
- File a formal appeal — most plans allow 30 to 60 days from the denial date
- Ask your doctor to request a peer-to-peer review (your doctor calls the insurance company's medical reviewer)
- Ask your HR benefits administrator to advocate on your behalf
- If your appeal is denied again, contact your state's insurance commissioner
We know this feels like a lot. That's exactly why we made the cheat sheet.
What About FSA and HSA Funds?
If your insurance doesn't cover your cranial prosthesis, you may still be able to use funds from a Flexible Spending Account (FSA) or Health Savings Account (HSA) for a medically prescribed wig. Check with your plan administrator to confirm eligibility and what documentation you'll need.
A Note on Financial Assistance (specific to cancer patients)
We also want to make sure you know about Family Reach, a national nonprofit dedicated to removing financial barriers for cancer patients. They offer financial planning support, resource navigation, and emergency relief funds. If you're navigating a cancer diagnosis and struggling with costs, please visit Family Reach.
Get the Free Cheat Sheet
We've put everything in this post — plus a document checklist — into a free one-page download you can take with you to every appointment and every insurance call.
It includes the exact billing and diagnosis codes, the questions to ask your insurance company, the checklist of documents you'll need, and what to do if you're denied.
Download your free Insurance Reimbursement Cheat Sheet here.
For those living with alopecia areata, the National Alopecia Areata Foundation (NAAF) has helpful information worth bookmarking.
You've been through enough. Let us help make this part a little easier.
With warmth and solidarity,
Pamela Shaddock & Dianne Austin Co-Founders, Coils to Locs
