Meaning of Tummy Tuck Insurance Codes: 15830 + 15847?

The 15830 code refers to removal of the overhanging skin, and this will be covered by insurance. The 15847 is a cosmetic add-on code and refers to moving the belly button up, tightening the muscles, and removing fat from the abdominal wall with liposuction or direct excision. It surprises me that your insurance company included the 15847 in the approval. I would proceed cautiously with that, because you may learn after the operation that it is in fact not covered and be responsible for a bill. I hope this helps!
Phillip Dauwe, MD

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.  

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!

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

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.

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

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.

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