Plastic Surgery

Gender-affirming mastectomy coding: why the cancer code (19303) draws flags, when payers direct chest surgery to 19318, and the documentation that carries necessity.

Start here The short version The whole change in a few lines. Patients do not hear a network status, they hear a surprise bill. The damage happens at the scheduling call, not at the claim. Under the No Surprises Act, an out-of-network surgeon at an in-network facility means the patient owes in-network cost-sharing — same […]

Facial feminization surgery is the most-denied gender-affirming procedure — read as cosmetic by default. WPATH letters and the perception argument are what flip it.

Billing for a new plastic surgery practice: why cosmetic cash masks the credentialing gap, what outsourcing costs during the ramp, and the day-one setup order.

Outsourcing plastic surgery billing costs 4-9% of insurance collections. The cash-revenue trap, the hidden payroll, and the three disciplines one hire cannot cover.

Autologous fat grafting (15771, 15772) to the breast is covered by federal law after mastectomy and non-covered for cosmetic augmentation. The diagnosis linkage decides which.

Brow ptosis repair (CPT 67900) is covered when the brow sits below the supraorbital rim with a ≤30° superior visual-field loss that improves on elevation — not for a cosmetic brow lift.

A benchmark from 20,000+ plastic surgery claims: payers delay far more than they deny and cause about twice the problems practices do.

Lymphedema takes the feet; lipedema spares them. That one sign, plus lipedema’s missing ICD-10 code, shapes every liposuction (15877-15879) coverage fight.

Ten OON billing and NSA arbitration options ranked: pure-play IDR shops, the law firms we love, and the question that sorts the field.