Although the Tummy tuck surgery is excluded under most insurance policies, a panniculectomy may receive coverage when medically necessary. A panniculectomy is an effective procedure that removes the redundant pannus of skin and subcutaneous fat located in the lower abdominal area. Panniculectomy is covered by insurance when performed to correct for structural defects of the abdominal wall (such as a hernia) or to relieve abdominal skin disorders such as:
- Skin infection such as cellulitis and abscess
- Contact dermatitis
- Skin moisture and malodor
- Hypertrophic and atrophic conditions of skin
- Persistent ulcer
- Skin inflammation
- Persistent local skin irritations
- Painful inflammation of the tissue
- Hernia repair
- Interference with activities of daily living
Most insurance companies will request:
- Dated photographs of the pannus hanging over the pubis and of the pannus elevated to expose the chronic, persistent, and refractory skin infection or irritation.
- Office notes from the treating primary care physician that reflect the chronic, persistent, and refractory skin infection or irritation that persists despite optimal medical care over a six-month period.
- A list of the medications that were prescribed during a six-month period and the length of time the agents were used.