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.

What is procedure code 15830?

CPT® 15830 in section: Excision, excessive skin and subcutaneous tissue (includes lipectomy)

What is the diagnosis for abdominoplasty?

Abdominoplasty when done to remove excess skin or fat with or without tightening of the underlying muscles is considered cosmetic and not medically necessary. Repair of diastasis recti is considered cosmetic and not medically necessary….

What is the CPT code for abdominoplasty with upper abdomen and flank liposuction?

An abdominoplasty or “tummy tuck” (CPT 15847 used in conjunction with CPT 15830) is considered cosmetic and not a covered benefit. A. Precertification is required for panniculectomy.

Is a Panniculectomy cheaper than a tummy tuck?

A panniculectomy is more expensive than a tummy tuck, but it’s often covered by medical insurance. The cost can range from $8,000 to $15,000, plus anesthesia and other extras. A tummy tuck is less expensive but is not covered by insurance. This elective procedure costs on average around $6,200.

Is a Panniculectomy the same as a tummy tuck?

Well, there is a difference. In short, a panniculectomy is a medical operation and an abdominoplasty or tummy tuck is a cosmetic operation. During the abdominoplasty, or tummy tuck, not only the skin but the muscles underneath the skin are tightened up.

What is procedure code 19318?

Reduction Mammoplasty (CPT® code 19318) – Surgical reduction of breasts in women due to size and persistent symptoms.

How is Panniculectomy medically necessary?

The surgery removes the excess skin and fat that hangs over the abdominal area. It may be indicated if the panniculus interferes with a person’s daily activities (ADLs) and/or results in severe skin conditions that do not resolve after medical treatment. A panniculectomy does not tighten the abdominal muscles.

What is abdomen Infraumbilical Panniculectomy?

An infraumbilical panniculectomy is the excision of excessive skin and subcutaneous tissue in the abdomen. It can be combined with lipectomy, which is the surgical removal of fatty tissue from different body parts, including the abdomen, to achieve better cosmetic results.

How do I get my 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.

How much weight do you lose after 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).