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Meaning of Tummy Tuck Insurance Codes: 15830 + 15847?

I have just received my approval for a tummy tuck from my insurance. I am having this done because of the overhanging skin left from have 4 children and have also had 4 invasive surgeries, 2 hip to hip and 2 belly button to groin. I now have an ulcer under the "apron" and if I do not use Nystatin continually it does not disappear. Aside from that, it will stink to high heaven, yuck! Code 15830 + 15847 is what I am approved for. Does this include lipo and tightening of the muscles?

Doctor Answers (7)

Cpt codes for aabdominoplasty

+1

As stated these codes refer to 15830 panniculectomy (removing the skin) which can be functional or cosmetic or to 15847 abdominoplasty which is consdiered cosmetic. White the first code may be covered, I am surprised that the second cosmetic code would be covered.  


Chicago Plastic Surgeon
5.0 out of 5 stars 48 reviews

Coding can be tricky

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The first code 15830 refers to removing the excess skin from the lower half of the abdomen, that hangs over and is causing the ulcer that your treating with nystatin ,due to moisture collection. The code 15847 is an add-on code used in conjunction with 15830 to include repositioning the bellybutton and tightening up the muscle layer.

Liposuction of the abdominal wall would be part of the covered procedure but liposuction of the back or any other area would not be covered

Joseph M. Perlman, MD
Houston Plastic Surgeon
4.0 out of 5 stars 11 reviews

Insurance codes

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You can see all the other answers there are very specific. I do have a question for you what insurance company do you have, because at least here in the KC area, no insurance will cover the abdominoplasty code.

Victor M. Perez, MD, FACS
Kansas City Plastic Surgeon
5.0 out of 5 stars 7 reviews

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Tummy Tuck Codes

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It would appear that you have been approved for your Tummy Tuck based on those codes. I would check with your surgeon and make sure what the exact break down will be now. This meaning what your out of pocket costs will be. You will want to know how much liposuction will cost. The muscles should be repaired during the procedure. For most Board Certified Plastic Surgeons this is standard practice unless for some reason the patient requests otherwise. Good Luck!

Miguel Delgado, Jr., MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 32 reviews

The Meaning of CPT (insurance) codes 15830 and 15847

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Regarding: "I have just received my approval for a tummy tuck from my insurance. I am having this done because of the overhanging skin left from have 4 children and have also had 4 invasive surgeries, 2 hip to hip and 2 belly button to groin. I now have an ulcer under the "apron" and if I do not use Nystatin continually it does not disappear. Aside from that, it will stink to high heaven, yuck! Code 15830 + 15847 is what I am approved for. Does this include lipo and tightening of the muscles?"

You are approved for a Full Tummy Tuck but you should verify it with your surgeon.

In 2006, Medicare threw out the old confusing code 15831 and clarified what parts of a Tummy Tuck may be covered by insurance and what will not be covered by diving the tummy tuck into an apron resection or panniculectomy (15830) and a cosmetic procedure which included muscle tightening with umbilical movement vertically (15847).

Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 63 reviews

Tummy tuck

+1

The codes are approval for an abdominoplasty and panniculectomy.  The muscles will (should) be tightened, but liposuction is a separate procedure and considered cosmetic; therefore, usually not approved.

Shahin Javaheri, MD
San Francisco Plastic Surgeon
3.5 out of 5 stars 2 reviews

Meaning of Tummy Tuck Insurance Codes: 15830 + 15847

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No liposuction is going to be approved but muscle repair might. But why not discuss with your chosen surgeon or his office? Best way to learn what is covered and what is not is to ask the operating surgeon and the hospital patient billing dept. From MIAMI Dr. Darryl j. Blinski

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 64 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.