Question:
Appealing

   — Lynne C. (posted on June 19, 2001)

June 19, 2001
The rash is only one of the comorbidities of medical necessity. Is it possible you have the others? I have all four.<br><br> Abdominoplasty is considered reconstructive when performed to correct or relieve structural defects of the abdominal wall (ICD-9: 701.8/708.9) and/or chronic low back pain (ICD-9:724.1) due to functional incompetence of the anterior abdominal wall. These conditions may be caused by: 1. Permanent overstretching of the anterior abdominal wall following one or more pregnancies; (ICD-9: 701.8.701.9). 2. Permanent overstretching (with or without diastasis recti (ICD-9: 928.84) of the anterior abdominal wall with a large or long abdominal panniculus (ICD-9: 278.1) following weight loss in the treatment of morbid obesity and resulting in the uncontrollable intertrigo (crease dermatitis, ICD-9: 692.9) and/or difficult ambulation (ICD-9 724.8). 3. Trauma or surgery to the anterior wall of the abdomen resulting in loss of muscle of fascial integrity or pain from scar contracture (ICD-9: 709.2). 4. Abdominal hernia following previous abdominal surgery (ICD-9: 553.201, 553.21).
   — [Deactivated Member]

June 19, 2001
Hi, the language of the denial seems to be pushing a dermatologist's or other physician skilled in this area's attention, rather than your use of an OTC medication. It seems like if an M.D. prescribes something which does not clear up the rash, then they will consider that the trial of medical intervention has not been successful. Seems like it would be worth it to see a dermatologist and try some meds. before trying to get approval again. Hugs, Joy
   — [Deactivated Member]