Panniculectomy is the surgical procedure that removes excess skin and body fat from the lower abdomen on patients suffering from obesity or who have had a significant weight loss. Abdominoplasty is a procedure involving the removal of excess abdominal skin and/or fat with or without tightening lax anterior abdominal wall musculature.
Panniculectomy/Abdominoplasty - 91444
The excision of excess abdominal fat and skin is most often a cosmetic procedure and is not a covered benefit. Exceptions for medical necessity or functional impairment may be made if the criteria listed in the medical policy are met.
If/when commercial employer group and MyPriority® individual plans cover certain surgeries, these surgeries are covered at a different cost-sharing level than our standard benefit coverage levels.
To verify member cost sharing, use the Member Inquiry tool and look in the Additional benefits drop-down menu for Certain surgeries benefit information.
Authorization is required for all patients.
Participating providers use the Auth Request online authorization tool
Non-participating providers use the authorization forms.
See the medical policy for codes that may apply and codes not covered.