Question:
Coverage for plastic surgery after WLS surgery

I have been approved for surgery procedure code 15831 (excision of excess skin & subcutaenous tissue including lipectomy and adominoplasty.) Yet Mayo Clinic won't do the adominoplasty (tightening of the adominal wall muscles) because the cost is too much and they state it is considered cosmetic surgery. They tell me I have to pay out of my own pocket for the adominoplasty if I want it, even though the procedure code 15831 that I have been approved for includes the adominoplasty in it. I am confused. Does anyone else or has anyone else gone through this? If so, please help me understand what is goin on. Or do you have any answer on how to work this all out with Mayo Clinic and my insurance company. I am really confused about this.    — Kathrine S. (posted on June 14, 2001)

June 15, 2001
I am approved for the same thing for July 31. I think your situation is ridiculous, and I sympathize with you greatly. Does your surgeon only have privileges at the Mayo Clinic? Can he operate elsewhere? I don't know a direct answer to have it worked out at Mayo, but I would give them a call and inquire. If you can't get resolution, go elsewhere. You really want what you've been approved for!
   — [Deactivated Member]

October 2, 2005
Finally...I got my "Tips for Getting Your Plastic Surgery Approved" worksheet on my website. It will help individuals who have medically necessary issues get their plastic surgery covered, at least in part, by insurance. Check www.drlomonaco.com under "Patient Resources"
   — DrL