Question:
Cost of panni??Modified abdominoplasty??.

Could anyone please share their physicians fee for modified abdominoplasty (without muscle tightening) or panni?? I need this surgery but my surgeon will not submit it for approval because they feel it is cosmetic. I am having hernia repair and breast reduction at the same time and that is all covered by insurance. I would love to have it done, one surgeon has quoted in the $4000 range for the "modified abdominoplasty". Anyone ever try to negoiate the surgeon fee if it is more than the other surgeon?? thanks, Grace    — Grace K. (posted on January 5, 2003)

January 5, 2003
http://www.plasticsurgery.org/profinfo/pospap/abd.htm http://www.plasticsurgery.org/profinfo/pospap/skin.htm show these to your doc ans ask them to atleast try to bill ins...if billed as a panni it should be covered...
   — bekka K.

January 5, 2003
I agree with Bekka that the Position Paper from the American Society of Plastic Surgery is a powerful information tool. I had a panniculectomy ($3000) and brachioplasty ($3500) last year. My secondary insurance provider approved this reconstructive surgery, no questions asked. However, my primary provider initially denied the surgery, forcing me into their appeals process. In the packet of information that I submitted to the appeals committee was a copy of the Position Paper....my surgery was approved within the week...and it is fairly rare for insurance to cover brachioplasty. If your insurance provider is approving the hernia repair, I think that there is a better than average chance that the panniculectomy would be approved as well. I cannot understand your surgeon's reluctance to submit the letter of medical necessity for this RECONSTRUCTIVE (not cosmetic) surgery. If he continues to be noncompliant with your wishes...and remember that you ARE the consumer, and either you or your insurance company will be paying his bill...you might consider obtaining a second opinion from another board-certified plastic surgeon. Best wishes!
   — Diana T.

January 6, 2003
Thank you for the replies. I pulled up the position papers on the website you recommended. Thanks!! This is my problem..Since I have had my RNY I have nearly constant back and hip pain. Not severe...just a constant ache. I know when I have my breast reduction that the surgery should improve my posture and back pain. But I am thinking that this will be the 3rd surgical repair of hernias. So, why wouldn't both surgeons I have seen submit the panni or modified abdominoplasty for insurance. Both plastic surgeons I have seen say in my case it is cosmetic...I don't have a hanging apron like a lot of post ops...just some extra skin. I am almost tempted to call the insurance myself but am worried that they could consider the other surgery they have approved already cosmetic and then I would have a real problem. The quotes I have are between 3,500 and 4,000 for the panni. I just don't know what I should do.??? Thanks for the info..I am definitely passing it on to the surgeon.
   — Grace K.

January 6, 2003
I had my tummy tuck two weeks ago today. My insurance, Aetna, will approve a tummy tuck with hernia repair. I thought I had a small hernia but as it turns out....it was just a stitch from my bypass surgery that didnt disolve. Anyways,,,,my point is....Alot of insurance companys will cover a tummy tuck with hernia repair. Email me if you have any more questions.
   — skymaxjr