Question:
When should documentation begin for skin removal?
Hi everyone! Today my question is to those who have gone before me and have had thier skin removal done. What I need to know is what kind of problems are documented and by whom to get approved to have the excess skin removed? And even more important, when should documentation begin? I am 5 1/2 months post-op and have lost around 89lbs. so far and have another 61lbs. to reach my goal weight. Thanks in advance!!! :) Open RNY~4/21/03~278/189/128 — wildchild (posted on September 30, 2003)
September 30, 2003
Hi Colleen: I'm waiting to hear from my plastic surgeon if I've been
preapproved by my insurance. I think it'll be another week or 2, so I'm
keeping my fingers crossed. I hope someone else whose farther along will
also answer you. But until then I'll tell you what I've heard. There are
several reason that a tummy tuck is considered medically necessary. Do you
have back pain? Do you have rashes under the excess skin? You should
already be having these things documented if you are experiencing them. I
haven't actually gotten a rash so I didn't go to my PCP for that, but I am
now just starting to go back to the chiropractor. I probably should have
gone sooner, but unlike you I wasn't smart enough to think ahead. :o) You
can go ahead and request the surgeon to get preapproval early, but you
won't want to have your surgery until you're within 20 pounds or less of
goal weight. If you don't get a more experienced person to answer you, and
you have more questions, feel free to email me. Good luck, S
— sherry hedgecock
September 30, 2003
From the day you lose the first pound. Dermatologist for the reashes, and
chiropractor for the pulling your back. Document often and thoroughly. It's
valid and you can prove it.
— vitalady
September 30, 2003
Personally I would start as soon as you are having any symptoms. If the
back pain is significant I would see your PCP about it and have them try
and document any permanent problems. This wll carry way more weight with
insurance than a chiropractor. There is nothing wrong with seeing a
chiropractor but documentation from an MD and a specialist goes much
further in the eyes of the insurance company.
<p>I have zero rashes but severe multilevel lumbar degenerative disc
disease which my neurosurgeon has documented and written a letter stating
that there is not doubt in his mind that an abdominoplasty will benefit my
condition. Hopefully this will be enough to get BCBS to approve it. It's
in for review right now. I hope to hear within a week or so. I need to
call the PS and make sure they have sent back the additional information
that has been requested by insurance. If this doesn't work then it's
likely self-pay for me because I am likely never going to have any skin
rash problems. Never did at 442 so I doubt they will sudenly surface now.
<p>If insurance will cover and the approval is only good till the end
of the year then I will lijely be having surgery a good 30-40 lbs from goal
weight. It would be very hard to accept giving up about $7000 in insurance
coverage just to wait till goal weight. Worst case is if I lost to lower
than my goal weight is that I would need a revision but it would be so much
less work and therefore a lot cheaper than the first time. I'm hopefull
that if I get an approval it will carry over into next year and be good for
6 months. That would be ideal as I have 65 lbs to goal.
— zoedogcbr
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