Would Like to Have Diastasis Recti Surgery Done Before End of This Year?

Question

I'v been diagnosed with diastasis recti and to have it done properly would require a tummy tuck to go along with it for it to look normal however my ins. will not pick up the tummy tuck portion of the surgery. I'm bummed out looking for a doctor that can code it appropriately to be covered.

Richard H. Tholen, MD, FACS · Answer

Diastasis recti is stretching of the abdominal wall fascia, usually from pregnancy or obesity. Repair of this is part of a properly-performed cosmetic abdominoplasty (tummy tuck).

	Diastasis recti is NOT a ventral hernia. Ventral hernia repair is an insurance-reimbursible expense, but not a tummy tuck.

	This is not a "coding" issue; coding it "appropriately" ensures it will be considered cosmetic and not covered, so stop looking for a surgeon who will commit insurance fraud. Save up and see an ABPS-certified plastic surgeon who is also an ASAPS member. Best wishes! Dr. Tholen

Ronald Schuster, MD · Answer

Unfortunately most insurance companies do not cover for the repair of diastasis recti. Reputable surgeons would not "code it" differently just to get it covered, which to some, would be considered fraud. Remember, if your surgeon is willing to lie to the insurance company, how do you know he/she wold not lie to you as well. The best plan would be to figure out a good way to save up the money. There are also good financing companies like CareCredit which might work for you. Good luck, and be careful.

Kurtis Martin, MD · Answer

There is no insurance coverage for a strictly cosmetic procedure ( normal tummy tuck). If you have a large apron hanging down with rashes and other symptoms, then you might get insurance to cover.

David Shifrin, MD · Answer

Insurance companies allow physicians to perform " medically necessary" procedures. No amount of convincing or manipulating of the system can change insurance companies stance. Hernia repairs are covered. Panniculectomy is sometimes covered. Cosmetic surgery (tummy tuck) is not.

	Cheers

Ryan Neinstein, MD, FRCSC · Answer

You should look at your local plastic surgery training program. Almost every program has an aesthetic clinic where residents learn how to do cosmetic surgery under the supervision of board certified plastic surgeons. Its a great way to get cosmetic surgery done safely and in an affordable way

	GOOD LUCK!

Would Like to Have Diastasis Recti Surgery Done Before End of This Year?

Answers (9)

Answer: Tummy tuck is cosmetic

Answer: Tummy tuck is cosmetic

Answer: TUMMY TUCK

Answer: TUMMY TUCK

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Everything you need to know about Diastasis Recti Repair

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Would Like to Have Diastasis Recti Surgery Done Before End of This Year?

Answers (9)

Answer: Tummy tuck is cosmetic

Answer: Tummy tuck is cosmetic

Answer: TUMMY TUCK

Answer: TUMMY TUCK

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Recommended reading

Everything you need to know about Diastasis Recti Repair

Our mission is to create a world where every investment in modern beauty is Worth It.