Author Topic: Billing code for insurance?  (Read 4302 times)

Offline ricochet

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I know that there are several billing codes that could be used for different procedeures. Does anyone know the code for liposuction, most likely to be approved by Blue Cross Blue Shield?

Linkback: https://www.gynecomastia.org/forum/index.php?topic=6829.0
-T

Offline Bradley07

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i'd like to know that, too. couldn't find anything on their website.

Offline ricochet

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Found code 19140 to be for Gynecomastia masectomy. With Blue Cross, you have to be pre-authorized for it to be covered and I don't know at this time what the qualifications are.

Offline Bradley07

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but is the standard gyno surgery considered a "masectomy"  ???  i don't think it is.

Offline ricochet

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I think you're right. Liposuction would not be, but incision would be. Maybe if your doctor could remove tissue with lipo, it could be coded as a masectomy. I'll find ou more this week.

Offline Bradley07

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Please let me know. I have blue cross/shield as well. I tried finding stuff on their website but no luck.  If you find anything, please share it--I have my consult on the 25th of September. Thanks!

Offline ricochet

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Blue Cross "BS" of Texas says that procedure is not covered.  >:( For any reason except breast cancer.

Offline Bradley07

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can you tell me where you found that info? i'm in another state (although i'm sure it'll be the same here). I pay so much for that crap every month and do you know that they have NEVER paid for anything of mine. Never. because i never meet their deductible amount. What a waste of freakin' money. If I had saved all the money i spent every month on their insurance i'd have enough $$$ now to pay for my gyne surgery. Idiots.  how can a man having breasts not be considered "medically necessary" surgery?  >:(

Offline ricochet

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I called their customer service and gave them the billing code. They used to cover it, but now have decided to disallow it. Your state may be different though. I hope you have better luck. They have paid for a few things for me after meeting my deductible. And then only pay 80%. I know what you mean about "waste of money".

Offline Warlord

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  • My battle with gynecomastia has begun.
Unfortunately, for the past few years it has been the norm for insurance companies to NOT cover surgery for gynecomastia.  

I went in for a consult on July 19th and the billing director at the plastic surgeon's office told me the tale of a 16-year old they had seen.  He had severe gynecomastia, registering around a C-cup, and had been going to a psychiatrist for two years prior to seeing Dr. K (my plastic surgeon).  The boy had major psychological and emotional problems, stemming DIRECTLY from the gynecomastia, but the insurance company (yes, in this case, it was BCBS) refused to pay for the surgery, calling it elective and not medically needed.  Dr. K's office fought for two additional years, before finally giving up and finding alternative financing for the kid.

It sucks, especially if you're one of the people who have had to deal with gynecomastia since puberty.  Unfortunately, though, it's the way things are, and until things change, it's up to us to shoulder the burden.

Any gynecomastia sufferer looking into surgery should NEVER consider insurance as a viable possibility...
« Last Edit: September 19, 2006, 04:06:26 AM by Warlord »


 

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