Question:
Who says PS is medically necessary?

Hi! I know that my insurance company only approves tummy tucks when it's medically necessary, but my question is who deems it medically necessary? Does the letter of medical necessity need to come from my PCP, my WLS surgeon, or a plastic surgeon? Thanks!! Beth    — Binxalways (posted on February 14, 2003)

February 14, 2003
Your PS writes a letter of medical necessity. This includes your weight history and the medical reasons you need this surgery. They also include photos. Additional letters can go to the insurance company with that letter, from other Dr's, like chiropractors, family Dr's etc...who ever has info on your medical condition dealing with the excess skin problems. IE: rashes, back pain.
   — ZZ S.

February 14, 2003
If you're not ready for the panniculectomy yet, make sure that you get documentation for every problem you have with it. Go to your PCP for any rashes, back pain, infection, etc. and make sure he/she puts it in your file. Then that info can be given to the PS when it's time.
   — garw

February 19, 2003
Hi Elizabeth. Exactly as stated below, you must document the problems the excess skin is causing and also the treatments that you have had. Some insurance readily covers this, other are more resistant. Be sure to choose a plastic surgeon certified by the Am Board of plastic Surgery (www.abms.org) and who you are comfortable with. Good Luck ! J.L.
   — DrL

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