Question:
Any one know about how much brachioplasty cost here in texas?

One more question...My surgeon submitted to United health for a panni...they denied me today for the abdominplasty?? How can they deny me for a procedure we didnt even request? I thought there was a difference between the two surguries..any theories?    — tylerswife (posted on October 8, 2003)

October 7, 2003
This is just a guess but maybe the surgeon is using a different code than United Health has for that procedure.
   — snicklefritz

October 9, 2003
An abdominoplasty is a full tummy tuck with the muscles shortened & the extra skin removed; a panniculectomy is where the extra skin alone is removed. Your doctor's office gives a cpt code to the precert people to get things reviewed for approval, if they used the cpt code for the full abdominoplasty, then the review is based on that. It all comes down to what the mdo requested. I do medical review and this is not the first time the mdo and the pt were on 2 different wave lengths. Usually most patients are very unaware of procedures and medical stuff and simply don't understand what there doctor is telling them, despite all the explanations and such. They often call to start a precert file and tell us really wild stuff, then we call the mdo and find out what is really going on. Now, I must note here that the people on this web site are, as a general rule, much more medically intelligent than the average person, so please don't feel offended by what I have said. Most of America hasn't a clue about medical stuff and really don't understand what their md has told them. Let me assure you, most insurance companies will not pay for this procedure unless it is reconstruction from injury/trauma, congenital defects, etc. This is considered a cosmetic procedure and most plans just don't cover it. Maybe your md can do something to help you, but maybe you will end up paying for it yourself if you really want it. I know I will have to pay full cost for myself and I work for one of the companies that sell health insurance!! Good Luck to you in your quest. karen morris
   — Karen M.

October 9, 2003
UHC denied my panni as well. Seems the cpt code for the full works is the same as the panni. After talking with my HR person it shows that the procedures are excluded in the policy, regardless of necessity. Weird thing was none of my denials ever came out and said that but that it was a fight between cosmetic & reconstructive. It gets worse as the policy also states they will not pay anything for complications etc arising out of a non covered procedure. I can't bring myself to put everything we own at risk incase I have some kind of complication down the road. I wouldn't be paid for the time off either. Good luck to you!
   — lessofme170

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