MEDICAL NECESSITY HELP!!! PLS RESPOND/REPLY

Sharekia W.
on 11/23/09 6:26 am
Post Date: 11/23/09 9:11 am

DOES ANYONE KNOW WHAT CONSTITUTES A MEDICAL NECESSITY FOR A TUMMY TUCK OR   PANNICULECTOMY? I HAVE A HERNIA BUT... ITS A HIATIAL HERNIA AND NOT IN MY LOWER ABDOMEN.

playwithzoe
on 11/23/09 9:29 am
It all depends on your insurance but your doctor will have to at least show a history of rashes and skin issues from the skin overhang.

46 yr old female; 5'6"; 11/13/08 VSG Dr. Jossart LapSF, SF, CA
SW 213, GW 150, CW 140, dream GW 130 and/or 20% body fat or less
12/22/09 mini face lift; Dr. Hove, Monarch Med Spa, KoP, PA
01/09/10 Reconstructive Surgery Dr. Sauceda, Monterrey, Mexico
U & L eye lid lifts, mini tt w/o muscle tightening, Brazilian buttock lift by fat grafting, Benelli BL & BA

Redhaired
on 11/23/09 12:06 pm - Mouseville, FL
You will have to see what your policy states.  But you might want to take a look at a couple of articles Dr. LoMonaco has written on insurance coverage.  http://www.drlomonaco.com/about-houston-cosmetic-surgery.sht ml



Red

  

 

 

Sharekia W.
on 11/23/09 1:21 pm
Thank you for the link. It was most helpful. I am on SC medicaid and I keep hearing different storiesas to if they will or will not cover. This site helped me to find the medicaid requirements. Thanks again.
Redhaired
on 11/23/09 1:31 pm - Mouseville, FL
I guess really the long and short of it is that one has to document that the extra skin is causing issues.  Be it skin breakdown and rashes, back pain, hernia or some other ailment.  The insurance company will be looking for documentation of persistent issues that are not responsive to less invasive treatment.

  

 

 

DrL
on 11/24/09 7:13 am - Houston, TX
What Red said...the plans vary so much is hard to say.

Best, Dr L
John LoMonaco, M.D., F.A.C.S.
Plastic Surgery
Houston, Texas

www.DrLoMonaco.com
www.BodyLiftHouston.com
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