Question:
Have a question in regards to the cpt code 15831 abdominoplasty

My PS wants to do the vertical and horizontal cut for my tummy tuck. This would take care on the panni and also that tire around my waist. My question was does cpt code 15831 cover that. That is what I was approve for. Does anyone have any info on this. The description for the code is very broad. I called the ins co and they told me it is up to the surgeon on how the procedure is performed but they have to use that code in order to get paid. My doc told me that if the ins does not cover the small tire around my waist it would cost $4000 extra. My thing is it would look stupid to have the bottom of my tummy flat and then have the tire around my waist to hang there. PS said that when he pulls the skin up and down the "tire" will not flatten out so the cut along my original bypass scar would be ideal so he can also contour my back and waist by pulling it together. Lord i hope I make sense. Please any help would be greatful.    — sarah C. (posted on May 28, 2004)

May 28, 2004
I have been researching tt and come across this site it is very informative. http://www.plasticsurgery4u.com/procedure_folder/abdominoplasty7.html
   — wizz46

May 28, 2004
What does the letter say that your PS submitted for the approval. If he used the same procedure code when asking for pre-auth then I would say you are covered. If he used a different one and they approved this one then you probably have an issue. <p>I do understand the issue of having the spare tire above the waist and the flat as a board below the waist, as that is what I have right now. However, I did have the vertical cut done with the first surgery but the PS told he going in that he would not be able to remove the upper panni completely with one surgery. Due to my waist being very anchored and therefore not allowing the skin to be fully loosened and pulled down there was no way to get it all. In my case the initial request was submitted indicating that two surgeries would be needed to complete the abdominoplasty and insurance agreed and approved both procedure right away. They did not approve the lateral thigh lift portion of the LBL, so I paid for that myself, which was about $6,000. On June 7th I am getting the upper part done and also a bunch of lipo on my thighs in preparation for having the thigh skin removed in Nov. I am paying for the lipo work in this surgery and will be footing the whole bill for the thigh lift/skin removal. It is a lot of money to lay out but at least by incorporating some of the work with other surgeries it reduced the cost considerably. <p>In my opinion, it will be worth it to pay the $4000 to get the complete job. Use a low interest credit card or borrow against your home, car, 401K, personal loan etc. I will be paying off some of my PS for a few years but it is worth it.
   — zoedogcbr

May 29, 2004
Hi. The CPT code is simply "removal of excess skin and fat, abdomen" Your PS will discuss with you what else needs to be done so you look "balanced" and how much he is going to charge for it. The average payments made to docs for code 15831 are nowhere near what a good tummy tuck, skin and muscle tightening, and liposuction would cost. If at all possible, get as much done at once as is safely possible ! The INS will cover the hospitalization in most cases, so the approval DOES help keep your out-of-pocket costs down !
   — DrL