Panniculectomy is a procedure done to correct an overhanging pannus, which is usually caused by losing an excessive amount of weight. This procedure is done to tighten the lower part of the abdomen, but usually will not give a patient the full correction they need unless it is combined with either a standard tummy tuck, extended tummy tuck, or a circumferential tummy tuck. Since the idea patient seeking to have a panniculectomy is suffering with panniculitis, which means one who has an overhanging pannus, the standard combination will be an extended tummy tuck, and for severe cases a circumferential tummy tuck will be suggested.
Patients suffering with panniculitis may also have rashes and infections caused by the excessive level of skin laxity in the lower abdominal area. Before seeking plastic surgery, a patient must go see their primary care physician in order to address these concerns and the majority of the time, a physician may recommend a visit with a board certified plastic surgeon that specializes in body contouring. Most patients will take antibiotics or use topical creams to decrease the development of these symptoms, but if this does not fix their problem then consulting with a plastic surgeon about panniculectomy surgery is the next step.
In some cases patients may have their panniculectomy covered by their insurance, but insurance plans differ and are based on medical necessity.
Tummy Tuck Insurance Coverage
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
Skin moisture and malodor
Hypertrophic and atrophic conditions of skin
Persistent local skin irritations
Painful inflammation of the tissue
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.