Any Way to Get Insurance to Pay for a Dorsal Hump Removal?

If your surgeon can document a functional issue (obstruction, airflow issues etc) with your nose which he/she believes is a result of your injury, then insurance would pay for that portion of the operation - the functional part. The dorsal hump may, or may not be related to the trauma that your received - but its a cosmetic issue. Expect to pay out of pocket for any cosmetic correction to your nose that does not also address a functional nasal problem.

If a direct linkage can be drawn for the dorsal hump or breathing problems to the documented nasal trauma then insurance companies will generally cover the procedure depending on your plan coverage.

If you had severe trauma that is well documented, it may be covered. This usually includes airway obstruction and proper evaluation through exam and CT studies.

The insurance coverage usually extends to surgeries that correct functional nasal problems, such as nasal obstruction.  Insurances also provide coverage for reconstructive surgery aimed at correction of nasal deformity due to prior trauma.  However, the deformity needs to be fairly severe to qualify for reconstructive procedure, such as severe nasal deviation, saddle nasal deformity, etc.  Correction of dorsal hump is really a gray area: from one hand it may indeed be traumatic in etiology, but from the other hand it is a pure cosmetic procedure. I would say, you need to be prepared to pay out of pocket for this, but get a few consultations and see for yourself what options you will be offered.

If your surgeon can document that the hump is the result of the nasal trauma by submitting photographs, CT scans, and any other relevant documentation, some insurance companies will cover reconstructive rhinoplasty to address this post-traumatic condition.  Other insurance companies have specific criteria that only cover functional repairs to improved a compromised nasal airway.  It is worth having a board certified plastic surgeon evaluate you, submit the documentation, and see if you can get coverage for this repair.

All the best,

Dr. Skourtis

Of course, insurance will cover repairs after any nasal injury. However, the key is clear documentation, cause and effect, and a predetermination from your insurance of your covered benefits.

If the dorsal hump or breathing problems are secondary to the documented nasal trauma most insurance companies will pay for treatment of these problems. Your surgeon's office can help you to clarify your coverage before surgery.

Hi,

The answer is yes. However, every insurance plan is different, some require preauthorization with proof of fracture and some do not. The surgeon and check this for you.

Best,

Dr.S.