Does insurance cover nasal tip ptosis?

Question

Does insurance cover Nasal Tip Ptosis? My nose is not too bad from a cosmetic point, however, I do want the tip smaller. However, I noticed that I can't get as much air through my nose as I think I should. I would say that I get 40% more air when I push my nasal tip up.

George Sanders, MD · Answer

Everyone's breathing improves when the tip is lifted, so just because that maneuver improves your breathing, it doesn't mean that this the correct treatment for your breathing problem.If you are having a breathing problem, see a surgical specialist who treats this type of thing. There may be turbinate enlargement, valvular collapse, or septal deviation that are present and that can be surgically corrected with insurance coverage.

Johnson C. Lee, MD · Answer

It may be difficult to get insurance coverage for nasal tip work as the tip itself is not considered a critical component of the external or internal valves which control airflow into your nose. If there is an anatomical obstruction or medical condition which is reducing your airway seen during your examination, insurance may cover that specific portion of the case. Any cosmetic portion will not be covered even if done at the same time. Prior authorization usually requires a detailed note and examination by your plastic surgeon to determine what is needed to treat your situation but also is not a guarantee that insurance will cover the procedure. Hope this helps!Johnson C. Lee, MD Plastic Surgery

William Portuese, MD · Answer

There are many issues inside the nose that can cause functional breathing issues such as deviated septum, terminate hypertrophy, valve collapse, allergies and chronic sinusitis. Each one of these issues are treated differently with medications or surgery. Once you have failed medical management for nasal obstruction, then consider surgical intervention. Medical necessity must be documented at the time of the examination consultation in order to be able to bill medical insurance for a functional problem. Changing the shape of the nose such as a rhinoplasty is considered cosmetic which includes lifting the tip of the nose. Expect to pay for that component of the surgery yourself.

Victor Chung, MD · Answer

Rhinoplasty is a surgery to change the shape of the nose for breathing or appearance.Nasal tip ptosis is drooping of the the tip of the nose. This is a cosmetic feature of the nose. If you notice that your breathing is better when you push the nose up, there is a chance you have a nasal valve issue. Supporting the tip may be opening your nasal valve, allowing more air into your nose. Improving your nasal by addressing the valve may be covered by insurance; however, changing the tip of the nose is a cosmetic procedure - not covered by insurance. I would consult with a rhinoplasty expert who can evaluate your nose and determine the level of your airway obstruction. They can also discuss potential changes to your nose that are appropriate for your face. Safety comes first.

Arian Mowlavi, MD, FACS (license on probation) · Answer

Nasal tip ptosis and enlarged shape are not considered part of medically covered procedures; BTW everybody can breathe better when their tips are elevated so that is not a maneuver used to diagnose functional breathing problems.

David Alessi, MD - Account Suspended · Answer

It is unlikely that insurance would cover elevation and support of a sagging nasal tip.  Having said that, there may be a nasal valve issue that insurance might cover.  A hybrid case where the insurance covers part and the patient pays part is probably your best scenario.  Seek a consult with someone double-boarded in ENT and Facial Plastics for a consult and have their office prepare a quote for a hybrid case, if appropriate.  Best wishes.

Does insurance cover nasal tip ptosis?

Answers (6)

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