Does insurance cover liposuction to drain a large hematoma from trauma caused by an auto accident?

Question

Several years ago my leg was smashed between a truck and a wall causing a hematoma the size of a basketball. It's now the size of maybe a large pear and still causes pain. I'm wondering if any insurance plans may cover this

Kenneth Hughes, MD · Answer

Insurance will usually cover drainage of a traumatic hematoma or surgery to correct it.Kenneth Hughes, MD

Jack Zoumaras, MBBS, FRACS (Plast) · Answer

Great question, I am unsure of he insurance circumstances in the USA. However, In Australia liposuction to correct a deformity of asymmetry associated with trauma is covered by both Medicare and Private Health Insurance companies. My advice would be see a Board Certified Plastic Surgeon who I am sure will be able to make the necessary enquiries. I would be surprised if you were not covered. In Australia, there may be some payment called a "gap payment" for the surgery, insurance covers the hospital costs.

Robert Kearney, MD, FACS · Answer

Yes insurance will cover the removal. I doubt it could be removed with liposuction, better removed by direct excision after a few xrays to confirm what the mass is.  MRI or CT scan.

Austin Hayes, MD · Answer

Yes, insurance is likely to cover the removal of the hematoma. You can only get specific advice from your doctor,  so speak with them about their thoughts. However it is almost certain that liposuction will not work properly. A collection of fluid/blood that has been in your leg for several years is encapsulated by a thick layer of scar tissue. Appropriate treatment requires incision, removal of scar tissue, drain placement, and closure of the space using sutures. Make sure you find an experienced board-certified plastic surgeon to take care of you properly.

Connie Hiers, MD, FACS · Answer

Typically, no, insurance would not cover the removal. However, ask your doctor to send a letter for prior approval to be sure. Your insurance company may need X rays to confirm, and you may need to see a plastic surgeon prior to be sure liposuction would be helpful. Your mass may need to be excised instead.

Bradley Remington, MD · Answer

Hello and I appreciate your question.  It sounds like you have developed scar tissue in the space of the previous hematoma if it has been several years from the injury.  Such tissue is characteristically very dense and fibrous and may not be amenable to reduction by liposuction.  An open excision of the tissue may be indicated.  If sufficiently documented, your insurance company may consider reimbursement for the procedure, but I would guess that a letter from your plastic surgeon would be needed.  I would consult a board certified plastic surgeon to examine you and recommend the best plan for you.
Cheers,
Brad Remington, MD

Mats Hagstrom, MD (license on probation) · Answer

In two years you know longer have a hematoma.
The first thing to do is to analyze the area most likely with an ultra sound.
If you do have a chronic fluid collection it will not be of blood but something called a seroma.
A chronic seroma generally needs to be surgically excised in order for it not to recur after the fluid has been removed.
Fluid buildup's can be removed using liposuction equipment but it would not be considered liposuction since fat would not be removed.
Insurance should pay for such a procedure regardless of how it's performed.
It's important to used the correct diagnosis when requesting insurance authorization for elective surgical procedures.
Best,
Mats Hagstrom M.D.

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