TT, MR and Umbilical Hernia Repair APPROVED!!!! - Portland, OR

I am not sure where to start.....my story is...

I am not sure where to start.....my story is simular to most of yours. I am 41 years old, married with two kids. I used to have a flat stomach in my 20's but after having the kiddos, it went downhill from there. I exercise 5 days a week and just cannot get rid of this extra skin and fat. I had my BR in July and am feeling well from that surgery. So at my follow-up appt with my PS, I asked him for info on a tummy tuck. He gave me the necessary information and checked my tummy to see if I was a good canidate. He said everything looked fine to procede with the surgery but I would need to have my umbilical hernia repaired. I said "What hernia?" He said it was small but should be fixed along with the tummy tuck. I do know that I have been having pain near my belly button for a few years now but never thought it was associated with a hernia. So he referred me to my GS to have it looked at. Both surgeons will do the surgery together. I am penciled in for Dec 21st. But now I am waiting for both surgeons to submit the necessary paperwork to my insurance and I am hoping they will approve it. I have looked at my insurance coverage for abdominoplasty and it clearly states that Abdominoplasty is considered medically necessary only if your pannus is hanging down below your pubis OR you have MR with a true midline hernia (umbilical or ventral).


Does anyone else have BCBSIL PPO that is having the same surgery I am that has been approved for this? What codes were used? What documentation did they need to approve it? Any info would be very helpful. Thank you!!

I just found out today that my surgery has been...

I just found out today that my surgery has been APPROVED!!!! I am so happy and excited. I was worried that I would have to pay for the tummy tuck portion of the surgery. Now I just have to tell my family that I am having surgery again. My pre op is on Dec 6th so I can go over the surgery details, ask all of my questions and get fitted for the compression garment. I will post pics soon....
Dr B

Referred to him by a close friend who is also a surgeon. Was impressed by his work and bed side manner too.

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