Question:
What do you think about this? Warning Long!!!

Hi AMOS family, I am in the process of requesting approval for an October 6th TT and revision on my breast reduction. I spoke with my insurance company Cigna EPO Open Access AZ back in April, the say the do cover with a letter of medical necessity. Here is the letter I sent to my PCP requesting it and what I would like in it. Would you please let me know what else I can do or if I need her to add some other items? Thanks you all are the best~~Love StephiAZ~~~ *********************************************************** Dear Dr Whitely, I hope all is well with you. As we had discussed before I am now in the process of requesting approval for my abdomnioplasty after my weight loss. I actually already have a date set of October 6th. I called your office to ask about having you submit a letter of medical necessity to my plastic surgeons office for them to submit to insurance. There are a couple of things that would help me immensely if you could add in the letter they are the following: ********************************************************** 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: *********************************************************** Permanent overstretching of the anterior abdominal wall following one or more pregnancies; (ICD-9: 701.8.701.9). (Please not that Stephanie has had 2 Caesarean sections. *********************************************************** 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). (please note Stephanie has lost a total of 135 pounds, has suffered rashes and debilitating lower back pain that has caused her to go through physical therapy) *********************************************************** Abdominal hernia following previous abdominal surgery (ICD-9:553.201, 553.21). ( Please note in addition to two Ce-Sections Stephanie has also had Open Duodenal Switch for the treatment of morbid obesity and also underwent a hernia repair in May 2003) *********************************************************** Anything else you can write will really help. Also I have attached a position paper by the ASPS regarding their position on skin redundancy, if you could refer to it and also attach a copy I would appreciate it. The Dr's office is just waiting on your letter so that they can submit for approval. When it is done could you please fax a copy to: Mary Ann @ Surgiplast 480-xxx-xxxx and a copy to me Stephanie Glesge 623-4xx-xxxx Thank you, you are the best! My phone numbers if you have questions are H-602-xxx-xxxx W- 623-xxx-xxxx and Cell 602-xxx-xxxx Stephanie Glesge    — Stephanie B. (posted on August 23, 2003)

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