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Pediculosis (lice infestation) treatment, topical, for administration by patient/caretaker

HCPCS code

Pediculosis Treatment: Topical Administration (A9180)

Name of the Procedure:

  • Common Names: Lice Treatment, Head Lice Treatment
  • Medical Term: Pediculosis Treatment, Topical


Lice treatment using a topical medication that the patient or caretaker can apply. This procedure involves applying a medicated lotion or shampoo directly to the infested areas to eliminate lice and their eggs.


  • Medical Conditions: Head lice, body lice, pubic lice (crabs)
  • Goals: To eradicate lice infestations, relieve itching and discomfort, and prevent the spread of lice to others.


  • Symptoms: Itching, visible lice, nits (lice eggs) attached to hair shafts, sores from scratching
  • Criteria: Presence of lice on hair or body, visual confirmation by a healthcare provider


  • Instructions: Wash hair with regular shampoo, towel-dry hair but leave slightly damp, do not use conditioner.
  • Assessments: Visual inspection by healthcare provider, possibly a lice comb-through to confirm infestation.

Procedure Description

  1. Step-by-Step:

    • Apply the recommended amount of topical treatment to dry or slightly damp hair.
    • Massage medication thoroughly into the scalp and hair, covering from root to tip.
    • Leave the treatment in for the manufacturer’s recommended time, generally 10 minutes to several hours.
    • Rinse out the treatment thoroughly with water.
    • Use a fine-tooth lice comb to remove dead lice and nits.
  2. Tools and Equipment:

    • Medicated shampoo or lotion
    • Fine-tooth lice comb
  3. Anesthesia/Sedation: Not applicable.


The entire procedure typically takes between 20 to 60 minutes, including application and rinsing time.


Generally performed at home following instructions from a healthcare provider.


  • Primary: Patient or caretaker
  • Supporting: Healthcare provider for initial guidance and follow-up if needed.

Risks and Complications

  • Common Risks: Mild irritation, redness, or itching at the treatment site.
  • Rare Risks: Allergic reactions, severe skin irritation.
  • Complications Management: Rinse the affected area with water, seek medical advice for severe reactions.


  • Expected Benefits: Eradication of lice and eggs, relief from itching and discomfort.
  • Timeline: Lice are typically killed within one treatment, though a second treatment is usually recommended 7-10 days later.


  • Post-Procedure Care: Continue checking for lice and nits, use a lice comb daily, wash bedding and clothing in hot water.
  • Recovery Time: Immediate return to normal activities, follow-up treatment usually needed within 7-10 days.
  • Restrictions/Follow-Up: Limit close head-to-head contact and sharing of personal items until lice are fully eradicated.


  • Other Options:
    • Oral medications for resistant lice
    • Manual removal and home remedies (e.g., vinegar, tea tree oil)
  • Pros and Cons:
    • Oral medications may be more effective but have more side effects.
    • Home remedies are less expensive but less proven and more time-consuming.

Patient Experience

  • During Procedure: Mild tingling or itching from the treatment.
  • Post-Procedure: Potentially a mild smell from the medication, generally, hair will feel normal after rinsing. Pain is not typically associated with this treatment. Comfort measures include using a clean, soothing environment and avoiding scratching.

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