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Thread: breast reduction with lipo of the axilla

  1. #1

    Default breast reduction with lipo of the axilla

    AAPC: Back to School
    I am in need of a specific site if someone has one. I have a surgeon who is charging patients separately for liposuction of the axilla done in conjunction with an insurance covered breast reduction. I have told him it is considered part of the insurance covered breast reduction but he maintains it's considered separate since it is lipo of the trunk. I maintain it is not since he is performing liposuction of the tail of spence for a smoother appearance. Can anyone point me in the direction of a site or anything to resolve this discrepancy? I am on the facilty side and of course we do not bill for it, but he is billing for it professionally and it is creating a problem. (the patients are questioning why they have to pay the surgeon and the facility is stating it is part of the insurance payment received)

    Thanks for your assistance!

  2. #2
    Join Date
    Apr 2007
    Coastal Coders


    From everything I can find it seems to be up to the surgeon. Some consider it part of the surgery others deem it an additional procedure. The surgeon should explain to the patient before the surgery that this is not covered by insurance as cosmetic.

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