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Abdominoplasty Panniculectomy

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Services that require precertification

Services that require precertification

www.ibxtpa.com

removal procedure (such as panniculectomy and abdominoplasty) • Otoplasty • Rhinoplasty • Rhytidectomy • Scar revision • Skin closures including: – Skin grafts – Skin flaps – Tissue grafts • Surgery for varicose veins, including perforators and sclerotherapy Experimental or investigational

  Panniculectomy, Abdominoplasty

Cosmetic and Reconstructive Services and Procedures

Cosmetic and Reconstructive Services and Procedures

www.uhcprovider.com

Abdominoplasty or panniculectomy are not covered when performed primarily for any of the following indications because it is considered not medically necessary (this list may not be allinclusive):- o Treatment of neck or back pain o Improving appearance (i.e., cosmesis) o Repairing abdominal wall laxity or diastasis recti

  Services, Procedures, Cosmetic, Reconstructive, Panniculectomy, Abdominoplasty, Cosmetic and reconstructive services and procedures

2021 Authorization and Notification Requirements Medical ...

2021 Authorization and Notification Requirements Medical ...

docs.ucare.org

2021 UCare Authorization & Notification Requirements – Medical - PMAP, MSC+, MnCare, Connect Revised 11/2020 Page 4 | 14 . Service Category Requirements CPT/HCPC Codes State Public Programs Medical Necessity Criteria

  Authorization, Eucar, Ucare authorization

Bariatric Surgery and Procedures

Bariatric Surgery and Procedures

static.cigna.com

Page 4 of 90 Medical Coverage Policy: 0051 . Procedure CPT ® Code(s) 43846 or 43847 and 43843 or 43999 Stomach aspiration therapy (e.g., AspireAssist

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