Redundant axillary tissue with early stage maceratation/rash excision may be consider a cosmetic procedure. There has to be an extensive rash/infection/painful to be deemed medically necessary. A letter has to be sent out with documented chronic problems in regards to that for the insurance company to even consider the excision of redundant skin.
So in the patient consult, maybe can bring that up as an additional cost as it is not medically necessary to remove and will not be covered by insurance companies.
hope that helps a little
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