Panniculectomy Pays. Abdominoplasty Doesn’t.
Panniculectomy (15830) is covered when the panniculus impairs function. Abdominoplasty is cosmetic. The add-on +15847 is the line where covered claims turn into denials.
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THE ANSWER: How many patients who come to you for a “septoplasty” have zero desire for a positive aesthetic outcome? Like they care 0% about how they look after surgery and are seeing you solely because their deviated septum has robbed them of their ability to breathe? None. They might say they don’t care, but […]
Rumored to be in existence, thought not to be…rare as the Tasmanian Tiger…the mythical Medicare Authorization does indeed exist. Worse yet, you need to know how to handle it, even though it technically is not a requirement for professional service providers (AKA Docs). So…what are we talking about here? As of 2020 Medicare started requiring […]
“The day you can fire me is one of the happiest days in our relationship” – Famous last words from John Gwin, CEO of The Auctus Group But seriously…why should you care? You’re a cosmetic / aesthetic surgeon. You’re making 2-3K+ per hour. Why would you ever lose money to deal with insurance? …Because you […]
THE ANSWER: Almost all payers, including Medicare/Medicaid DO cover/WILL cover REMOVAL of implants placed for any reason w/ Bakers III+ and/or Rupture. PAY ATTENTION HERE: they cover ONLY removal of implant/extracapsular material, perhaps capsulectomy/capsulotomy, and NOT revision/replacement UNLESS there’s a personal history of breast cancer or mastectomy for prophylaxis. So…tell that patient we can […]
Raise your hand if you want to go to school for 15 years and then stand for 8 hours turning a stomach into a breast and get paid $500 per hour for your expertise? Are you familiar with microvascular anastomosis? Yeah, you gotta do that stuff too. Do you skeletonize vessels in your free time? […]
SO THIS IS WEIRD…A BIT ABOUT US So, I have a Google Alert setup for our company, and in the past few weeks I’ve gotten some alerts that these random sites are writing about us… Looks to me like they are semi-bogus sites trying to push folks to buy these “market research” reports, which I’m […]
Search engines handle approximately 2.45 million searches for health-related topics, and over 100,000 searches for “plastic surgery” every month. Just think about what the right search engine optimization (SEO) strategy can do for your plastic surgery practice. SEO is using a set of practices to improve the positioning and appearance of your web pages. It […]
THE QUESTION: I’M THINKING ABOUT HIRING A NURSE PRACTITIONER OR PHYSICIAN ASSISTANT…HOW DOES THE BILLING WORK? THE ANSWER: Great question! Long answer…I’m going to make more questions than I answer here I think… Can the midlevel bill under the MD? In short, yes…but you have to be careful and adhere to the regulatory guidelines. This […]
So, I got an email from a client, with a great question and thought I would share our reply! The Question: What the average insurance pay-out is for a small in office cyst or lipoma removal. Wondering if we should be submitting or billing cosmetically? The Answer: Good question. They are medically necessary procedures typically […]
What’s the top priority: The Application or the Follow Up? Riddle me this: What is more important in any paperwork submission process: 1) The initial application itself? 2) The follow up work? Of course, the application should be complete with 100% accuracy, this is critical. In the medical insurance contracting and credentialing world, however, the […]
