My insurance will cover a panniculectomy, is it possible to have abdominoplasty done at the same time and pay the difference?

Hello! Absolutely! In fact i encourage my patients to do so! If it is an issue with your insurance company you can speak to someone in member benefits to learn more. Any experienced Medical Biller will be able to correctly inform your insurance company which procedure was cosmetic and which is medical in nature. 

I have seen this occur as well as insurance companies are very aware of  insurance fraud that is occurring very often. The insurance company does not like to be taken advantage of. Due to the significant increase in wound healing complications from panniculectomy I refer theses case to the local teaching hospital where a team of doctors and residents are available to manage the complications. A full abdominoplasty may be the right operation for you and you can always stage this by doing 2 separate surgeries. This is likely safer too, Good Luck!

If you are a candidate, you can certainly discuss with your surgeon financial arrangements for the surgery. Best of luck.

This is actually an excellent question and deserves a response.  Your insurance company will cover panniculectomy because you're having infections and problems in the pannus.  If you choose to upgrade your result to that of an abdominoplasty and pay the difference, that should be an acceptable option for the insurance company, as well as to your surgeon.  As long as you are open and disclose this prior to the operation to them, I have seen this covered.  The problem is that there are occasionally active infections going on when panniculectomy is done, especially of a fungal nature.  This can lead to increased complications and needs to be done very carefully and with an anticipation of probable problems.  It is quite common for us to do a breast reduction as an example and have that paid for by the insurance company and at the same operation do a cosmetic procedure like an abdominoplasty.  As long as you are open and disclose all this prior to the procedure, I do not anticipate there should be a problem.  You should anticipate paying  an additional fee not only for the surgeon but also for the added anesthesia time and facility fees.

yes it is possible.   There are separate codes for panniculectomy anabdominoplasty which is considered cosmetic.   Only the panniculectomy is submitted to insurance, not the abdominoplasty portion.  You would pay the cosmetic abdominoplasty surgery, hospital fees and anesthesia fees separately.  Your surgeon would need to describe the time the panniculectomy ends and the abdominplasty begins.  I sometimes recommend these be done separately if it is a very large panniculectomy and safer to do them separately..  good luck!

The short answer to your question is yes. IF the insurance company will pay for the panniculectomy for functional reasons you can pay for the cosmetic part of the procedure out of pocket. Of course this will have to be verified with your insurance company. Good luck!