31 yr old female with 2 children (2009, 2011). 93 lbs/active. I have a substantial separation in abdominal wall and an umbilical hernia the size of a golfball. I have contacted my ins. provider and they will not cover any repair to my abdominal wall unless it is to repair the hernia alone. Seems odd to me considering a hernia may occur again later due to the separation. Are there any doctors that will repair the separation and the hernia simultaneously with a CPT code that fits the insurance guidelines?
Answer: Hernia Repair, Correction of Diastasis, Tummy Tuck Surgery?
Thank you for the question. Based on your description, it sounds like you are an excellent candidate for abdominal wall contouring surgery. There is a greater chance than not that the hernia repair will be covered through health insurance. In my experience, insurance companies will not cover correction of diastasis recti.
I hope this, and the attached link, helps.
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CONTACT NOW Answer: Hernia Repair, Correction of Diastasis, Tummy Tuck Surgery?
Thank you for the question. Based on your description, it sounds like you are an excellent candidate for abdominal wall contouring surgery. There is a greater chance than not that the hernia repair will be covered through health insurance. In my experience, insurance companies will not cover correction of diastasis recti.
I hope this, and the attached link, helps.
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CONTACT NOW Answer: Insurance coverage with hernia and or diastasis recti Insurance companies typically cover hernia repairs (umbilical, inguinal, ventral) but will not cover diastasis recti as that condition is not a true hernia. In office we commonly repair small umbilical hernias at the same time as an abdominoplasty but any larger hernia requiring extensive repair and/or mesh would need to be corrected by a general surgeon first. Good luck in the rest of your research and decision making with your repairs.
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CONTACT NOW Answer: Insurance coverage with hernia and or diastasis recti Insurance companies typically cover hernia repairs (umbilical, inguinal, ventral) but will not cover diastasis recti as that condition is not a true hernia. In office we commonly repair small umbilical hernias at the same time as an abdominoplasty but any larger hernia requiring extensive repair and/or mesh would need to be corrected by a general surgeon first. Good luck in the rest of your research and decision making with your repairs.
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June 17, 2013
Answer: Insurance coverage
The answer you got from your insurance is exactly what I would expect. they will pay for a true hernia such as an umbilical hernia, but not much. Insurance companies are wise to the rectus diastasis ruse, no matter how severe or symptomatic it is.
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Answer: Insurance coverage
The answer you got from your insurance is exactly what I would expect. they will pay for a true hernia such as an umbilical hernia, but not much. Insurance companies are wise to the rectus diastasis ruse, no matter how severe or symptomatic it is.
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June 13, 2013
Answer: Can Diastasis Recti and a Hernia Repair Be Covered Under Insurance Depending on Your Doctor and CPT Code?
I have been in practice 14 years. Insurance will cover an umbilical hernia repair but I have never had them approve coverage for diastasis of the rectus muscles. Trying to get insurance to pay for a diastasis repair under a different code is considered insurance fraud.
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Answer: Can Diastasis Recti and a Hernia Repair Be Covered Under Insurance Depending on Your Doctor and CPT Code?
I have been in practice 14 years. Insurance will cover an umbilical hernia repair but I have never had them approve coverage for diastasis of the rectus muscles. Trying to get insurance to pay for a diastasis repair under a different code is considered insurance fraud.
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June 13, 2013
Answer: Diastasis Recti not Typically Covered by Insurance
While repair of umbilical hernias is normally covered by insurance, a diastasis repair typically is not. There is no way to make it covered and still be honest and ethical. In rare cases, if pain can be attributed to a diastasis, I have seen it covered.
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Answer: Diastasis Recti not Typically Covered by Insurance
While repair of umbilical hernias is normally covered by insurance, a diastasis repair typically is not. There is no way to make it covered and still be honest and ethical. In rare cases, if pain can be attributed to a diastasis, I have seen it covered.
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June 13, 2013
Answer: Diastasis is usually not covered by insurance.
Abdominal wall hernias are usually covered by insurance but diastasis, which is a wide separation between the two rectus muscles, is usually not. You can call your insurance broker to find out.
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Answer: Diastasis is usually not covered by insurance.
Abdominal wall hernias are usually covered by insurance but diastasis, which is a wide separation between the two rectus muscles, is usually not. You can call your insurance broker to find out.
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