Is a Panniculectomy considered reconstructive surgery?

However, panniculectomy is considered reconstructive when performed to correct or relieve structural defects of the abdominal wall, irregularities or pain caused by prior pelvic or lower abdominal surgery, intertriginous skin conditions and scarring.

Is Panniculectomy considered cosmetic surgery?

A panniculectomy is surgery to remove this excess tissue. A panniculectomy may be cosmetic (to improve looks only). The plan does not cover cosmetic surgeries. There are some instances, however, where the panniculus is causing medical problems that interfere with a person's everyday functioning.

Will medical cover a Panniculectomy?

Panniculectomy is considered not medically necessary when the criteria above are not met. Panniculectomy is considered not medically necessary as an adjunct to other medically necessary procedures, including, but not limited to, hysterectomy, or incisional or ventral hernia repair unless the criteria above are met.

Does insurance cover Panniculectomy after weight loss?

Though heavy, excess skin left behind after weight loss can be considered a medical condition due to discomfort and increased risk for skin conditions, most insurance providers do not cover body lift surgery.

Is Panniculectomy medically necessary?

Panniculectomy is considered not medically necessary unless the clinical criteria above are met. Panniculectomy or abdominoplasty, with or without diastasis recti repair, for the treatment of back pain is considered not medically necessary.

Tummy Tuck vs Panniculectomy | Greer Plastic Surgery | Cleveland, OH

How do you qualify for a Panniculectomy?

How much weight is removed in a Panniculectomy?

Results: Average abdominal skin resection was 16.1 pounds, ranging from 10.3 to 49 pounds. Hernia repair was necessary in 13 patients. Additional surgery performed at the time of panniculectomy included skin reduction surgery of the back (40 percent), chest (32 percent), inner thigh (28 percent), and arm (28 percent).

How do I get insurance to cover a Panniculectomy?

Since the panniculectomy is not typically seen as a cosmetic surgery, your insurance provider may help pay for the procedure. But, you must meet specific criteria, and the panniculectomy must be seen as a medical necessity. Contact your health insurance provider to discuss your payment options.

Is a Panniculectomy the same as a tummy tuck?

The biggest difference is the goal of the surgical procedure. A tummy tuck tightens the abdominal muscles and removes excess fat, skin, and tissue, while a panniculectomy is performed to remove a pannus.

Do I need a tummy tuck or Panniculectomy?

They may both be performed in cases of extreme weight loss from natural or surgical causes. The goal of panniculectomy is to primarily remove hanging skin, while a tummy tuck also provides contouring effects to enhance your muscles and waistline. It's also possible to have both procedures done at the same time.

What is a medically necessary reason for having a tummy tuck?

In flattening the abdomen and removing excess stomach fat, a tummy tuck surgically tightens the weakened muscles, resulting in much-needed abdominal support that can alleviate your back pain. To improve posture: A byproduct of stronger abdominal muscles and decreased back pain is improved posture.

Does a Panniculectomy remove fat?

Panniculectomy is a surgery done to remove stretched out, excess fat and overhanging skin from your abdomen.

Does insurance pay for skin removal after gastric sleeve?

Insurance companies typically cover weight loss surgery, but don't always cover cosmetic surgery to remove excess skin after significant weight loss.

What is the CPT code for Panniculectomy?

One code, CPT 15830 for panniculectomy, can be billed to insurance when appropriate; the other code, CPT 15847 for abdominoplasty, describes a cosmetic procedure and therefore should not be billed to insurance.

How long is recovery after a Panniculectomy?

It's normal to feel tired while you heal. It can take 5 to 6 weeks for your energy to return. You won't be able to stand up straight when you get home. To regain your normal movement, you'll need to get up and walk every day.

Do Panniculectomy scars go away?

Like all surgical scars, abdominoplasty scars will never go away completely, but most patients feel they are well worth the benefits of achieving the smooth and flat abdominal contour they desire. Dr. Schlechter places the incisions as discreetly as possible to minimize scarring so that you can enjoy the best results.

What is an extended Panniculectomy?

Extended tummy tucks work by removing excess skin and fat from the abdomen and repairing any muscles that have become loosened or torn. Through an incision above the pubic hairline that wraps around to the lower back, skin and fat are removed from the stomach and flank area.

What is the BMI for a Panniculectomy?

Reaches a body mass index (BMI) less than or equal to 30 kg/m²; or. Has documented at least a 100 pound weight loss; or. Has achieved a weight loss which is 40% or greater of the excess body weight that was present prior to the individual's weight loss program or surgical intervention.

What is included in a Panniculectomy?

A panniculectomy surgically removes a pannus. A pannus is excess skin and adipose (fatty) tissue, sometimes referred to as an apron, that hangs down over the genitals and/or thighs.

Where do they cut you for a Panniculectomy?

A panniculectomy requires a horizontally-oriented incision in the area between the pubic hairline and belly button. The shape and length of the incision will be determined by the amount of excess skin.

How much weight should I lose before a Panniculectomy?

However, the surgical procedure is not a replacement for weight loss. It is important that you be close to your desired weight for six to twelve months before undergoing a tummy tuck. Most surgeons will recommend patients be between 10-15 pounds from their goal weight.

How long does it take for insurance to approve Panniculectomy?

information from your visit is sent to your insurance company for authorization. This process can take from 14-60 days. medical information, your insurance company will make the decision about whether to cover your panniculectomy.

How much does it cost to get loose skin removed?

Excess skin removal surgery costs

These are the average costs for the most common plastic surgeries for loose skin after weight loss, according to the 2020 Plastic Surgery Statistics Report: Panniculectomy: $8,000-$15,000. Lower body lift: $7,924. Upper arm lift: $4,861.

How painful is skin removal surgery?

Excess skin removal procedures are major surgeries. You can expect to have pain for a few weeks. Your healthcare provider will prescribe pain medicine and offer tips to ease discomfort. You may have more pain when moving around, climbing stairs or getting off the couch.

Will insurance cover a tummy tuck after weight loss?

Commonly performed treatments are skin reduction of the arms (brachioplasty), breasts (lifts and reductions), tummy tucks, and thigh lifts. In today's times, these procedures are almost always considered “cosmetic”. This translates into no insurance coverage.