Will insurance cover an endoscopic brow lift to help with visual field obstruction, or only open coronal?

You should get in writing from your insurance company that the "pre-approval" for your browlift applies to a different surgeon. If they do not provide that for you, you should get re-approval with the new surgeon.

As far as insurance coverage for browlift goes:  it is a tenuous proposition. Sometimes they do and sometimes they don't....even when you have the so-called "pre-approval". Furthermore, the reimbursement they provide is extremely low compared to the amount of work a surgeon needs to do for a hairline, endoscopic, or coronal browlift. These are significantly more complicated procedures, and are much more difficult to get the desired lift a brow needs for a functional need [to improve vision]

For these reasons, most surgeons would only do a 'direct' browlift, which means the incision is directly above the eyebrow in the forehead. Although, with time, this heals well, there will be a scar visible above the eyebrow. This is a more effective technique in elevating the eyebrow for functional reasons, but it is not the most cosmetically ideal incision. But then again, if the surgery is being paid for by insurance, cosmetic incisions shouldn't be used, right?

Good luck

Insurance coverage for a procedure usually (not always) would apply if you change surgeons, however the entire process needs to be restarted- you can't just "transfer" it.  Also, keep in mind, just because a surgery/procedure is pre-approved or pre-certified, this does NOT guarantee the insurance company will pay the surgeon.  Then the financial responsibility falls on you, the patient.  This has happened to me many times, which is why I am exhaustive in explaining this to patients before surgery.  I also instruct patients to contact their insurance carriers directly themselves to verify what their out-of-pocket costs will be in addition to this (depending on your individual plan).  Yes, this seems like a very slippery, non-commital way for insurance companies to do business, and I have no idea why they are able to do this- if insurance companies decide after surgery not to pay, it's not as if the doctors can "un-do" your surgery or anesthesia, like you are returning a purchased physical product such as a chair or a desk lamp.  This is an illogical business model and a sore topic in health insurance coverage that could take hours to discuss.  Sorry for sounding pessimistic, but I just want to be truthful.

There is not a specific procedure code for an endoscopic browlift procedure. Therefore, the insurance approval should cover other approaches. However, you should direct this question to your surgeon's office as they have the actual letter and know the details of your care. In my experience, an endoscopic browlift is inadequate to remedy the amount of brow droop that results in vision impairment. Therefore, in most cases, I will perform some type of "open" browlift procedure for procedures like the one you require just as your surgeon has suggested. I hope this information is helpful.

Stephen Weber MD, FACS

Lone Tree Facial Plastic Surgeon