Insurance Coverage Criteria for Panniculectomy and Redundant Skin Surgery after Bariatric Surgery: Why and When to Discuss

A dramatic increase in bariatric surgery has increased the number of patients with redundant skin/large panniculus after massive weight loss. This is best treated by surgery; however, not all patients with redundant skin/panniculus get authorization from insurance providers. There are certain insura...

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Bibliographic Details
Published in:Obesity surgery 2009-04, Vol.19 (4), p.517-520
Main Author: Gurunluoglu, Raffi
Format: Article
Language:English
Subjects:
Abdominal Fat - surgery
Adipose Tissue - surgery
Bariatric Surgery - economics
Dermatologic Surgical Procedures
Gastrointestinal surgery
Guidelines as Topic
Humans
Insurance Coverage
Insurance, Health, Reimbursement - economics
Medicine
Medicine & Public Health
Plastic surgery
Review
Surgery
Weight Loss
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Summary:A dramatic increase in bariatric surgery has increased the number of patients with redundant skin/large panniculus after massive weight loss. This is best treated by surgery; however, not all patients with redundant skin/panniculus get authorization from insurance providers. There are certain insurance coverage criteria for panniculectomy that need to be met by patients for approval. Our search also demonstrated that there are not established criteria/guidelines for different body parts such as inner arms and thighs other than the pannus amongst third-party payers. These cases are appraised individually by third-party payers based on presented signs and symptoms. It is of utmost importance that members of a bariatric team are knowledgeable on these guidelines and should be able to discuss if necessary; however, currently utilized criteria should be discussed with patients, preferably in pre-bariatric surgery phase, and ideally by a plastic surgeon. Advantages are several-fold and discussed in the article.
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-008-9752-z