Question:
Is it easier to get insurance to pay for a panniculectomy than a tummy tuck?

I really don't need a tummy tuck, my abdominal muscles are pretty tight, you just can't tell because I've got all this skin hanging around! Does anyone know if insurance is more likely to pay for a panni than a TT? I guess a panniculectomy sounds less "cosmetic" than a TT. Thanks!    — Angie M. (posted on July 24, 2003)

July 24, 2003
Yes! Have your surgeon submit for a panniculectomy. Many will then do the muscle tightening part for free, or with a small additional fee.
   — mom2jtx3

July 24, 2003
What is the difference in a TT and a panniculectomy?
   — cutebrunette 1.

July 24, 2003
Insurance will pay for a Adbominoplasy or panni; It gets confusing.. I was aproved for a Abdominosplasy but NOT the 'muscles'.... seems my insurance used the words interchangeable... If you dont need the 'muscles' still get the abdominosplaty without the muscles. NOT just the panni. the panni will just remove the lower skin; the abdomio will remove the lower skin and any 'extr' on your tummy; and can be done WITHOUT the muscles; my plastic said I wouldnt notice any differnce until later.. without the muscles the skin would get 'a little' loose; but thats not an issue with me... Just have your surgeon put in for an Adbonioplasy with out the muscles...
   — star .

July 25, 2003
Well, I think there is a little confusion going on. I just had an abdominoplasty surgery on July 8th and yes indeed they reconstructed my abdominal muscles. It doesn't really matter what the wording is on your letters to the insurance company, they (insurance company's) pays for whatever the procedure coding that he PS submits. My insurance company approved me for a Panniculectomy however my surgeon submitted for an Abdominoplasty. I called the insurance company asking why I was approved for panniculectomy and they said it was the same thing and that they had approved whatever my surgeon submitted for. WRONG! Not the same thing. Panniculectomy is when only the hanging skin skin is cut off and abdominoplasty is when your abdominal muscles are reconstructed and they take the skin below your breast bone and pull it down to your pubic line and cut off all the remaining skin. Also a new belly button is made. So ladies, it really doesn't matter what the insurance company calls the procedure, it's all determined on what procedure codes the surgeon submit for approval. Think about it..... panniculectomy...cutting off panni....abdominoplasty....reconstructing abdominal muscles. The bottom line is you must approved this procedure to be medically necessary before any insurance company will pay. When I was approved I have to prove with documentation of lower back pain, rash, and photos proving my skin hung below my pubic line. In addition, my insurance company denied me at first stating it was cosmetic but I appeal and demanded it was reconstructive. By the next day after my appeal review I was approved.
   — Jeanette D.

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