What do the tummy tuck insurance codes 15830 and 15847 mean?

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I have recently received approval from my insurance for a tummy tuck. This procedure is necessary due to the overhanging skin caused by multiple pregnancies and previous invasive surgeries. I currently have an ulcer under the "apron" of excess skin, which requires continuous use of Nystatin to manage. Additionally, the area can become malodorous. The approved procedure codes are 15830 and 15847. Does this coverage include liposuction and muscle tightening?

Asked by DazzlingLullaby
2019-08-29 00:51:28

4 Answers

Answer

Answered by Lovely C. Laban, 15/08/2023 08:04

Based on my experience in the Kansas City area, insurance companies typically do not cover abdominoplasty procedures. It would be helpful to know which insurance company you have to provide more specific information.
Answered by Steven Wallach, MD, 15/08/2023 08:04

The 15830 code corresponds to the removal of overhanging skin, which is typically covered by insurance. On the other hand, the 15847 code is a cosmetic add-on that involves moving the belly button up, tightening muscles, and removing fat from the abdominal wall through liposuction or direct excision. It is surprising that your insurance company approved the 15847 code. I would advise proceeding with caution as there is a possibility that it may not be covered, leaving you responsible for the bill. I hope this explanation helps clarify the situation. Best regards.
Answered by Shaun Patel, MD, 15/08/2023 08:04

Regarding coding, the first code 15830 refers to panniculectomy, which can be functional or cosmetic, involving the removal of skin. It is possible for this code to be covered. However, the second code 15847, which is considered cosmetic for abdominoplasty, may not be covered.
Answered by Steven L. Greene, MD, 15/08/2023 08:04

The provided medical codes 15830 pertain to the removal of excess skin from the lower abdomen, repositioning the belly button, and tightening the muscle layer. Liposuction of the abdominal wall may be covered, but liposuction of other areas would not be covered. It is advisable to consult with your insurance provider for specific coverage details.

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