Does insurance cover pre-op testing?

Question

Hi I am scheduled to have a breast augmentation and liposuction on August 2nd and I was wondering if insurance covers the pre-op testing?

Christopher V. Pelletiere, MD · Answer

For preoperative testing and insurance coverage, it all depends on your health insurance carrier and how the surgeon codes the diagnosis.  If they put down a cosmetic surgery code then this is usually not covered.  However, if they put down a medical code such as micromastia or breast dysplasia ( small breasts) they be able to get coverage.  I would talk to your board certified plastic surgeon and see what they usually do. I hope this helps.

Brian K. Reedy, MD · Answer

Hi & thanks for your question!
Some insurance companies will cover pre operative testing. Reach out to your carrier and see if this is a covered benefit under your plan. Best wishes!

Daniel Barrett, MD · Answer

Dear toriamel,
this will depend on your insurance. In some cases, insurance company will cover the costs of pre-op testing. If you are considering a surgery, I would suggest you to consult your insurance for more information. 
Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Eric Schaffer, MD, FACS · Answer

Great question.  Generally the labs we order for surgery are your typical labs that your primary doctor would order yearly for your physical which are usually covered by insurance.  Some insurance companies only pay for services that are ordered by your primary so check with your insurance company plan for that stipulation.  Good luck.

Jeffrey J. Roth, MD, FACS · Answer

Thank you for your question.  Each health insurance company usually has several different policies.  The pre-operative coverage of labs varies widely.  The Board Certified Plastic Surgeon you are with may know which may be helpful in your city.  Best to contact the health insurance company and ask.  Also, most laboratory groups will have a cash pay price.  Jeffrey J. Roth, M.D., F.A.C.S.Board Certified Plastic SurgeonLas Vegas Plastic Surgery

Kenneth Hughes, MD · Answer

Coverage of lab tests prior to lipo and breast augmentation will depend upon your insurance provider. My patients are cleared for surgery by their PCP and specialists if necessary.  The tests needed will vary with age, current medical problems, and personal preference to some extent.  Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon
Los Angeles, CA

Daniel Shapiro, MD · Answer

Hello and thank you for your question. We advise our patients to get their pre-operative labs ordered through their primary care physician if they were hoping to get it covered by insurance as many plastic surgeons are not affiliated with insurance companies. Most insurance companies cover standard blood tests which is typically required for pre-op clearance

Stephen T. Greenberg, MD, FACS · Answer

Thank you for your question.  Each insurance company has their own protocol.  I don't typically find it to be a problem.  I would speak to your surgeon and your primary care doctor and see what they say.  Best of luck to you.

Shwetambara Parakh, MD · Answer

Fortunately yes ! pre-op testing involves regular lab-work and other routine tests and insurance does cover these

Matthew A. DelMauro, MD, FACS · Answer

Hello, and thank you for your question. (Keep in mind that an in-person consultation is necessary for the best advice.) Your medical insurance provider likely will not cover preoperative testing for an elective aesthetic procedure. Sometimes medical insurance providers cover blood tests as a part of a yearly physical exam and wellness checkup by a primary care physician. You should read your medical insurance certificate of coverage. Best of luck!
Matthew A. DelMauro, M.D.

Does insurance cover pre-op testing?

Answers (17)

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