and the Liposuction for Lipedema Reimbursement website. Our goal is to provide accurate, up-to-date, computer-readable text and spreadsheets so anyone can file medical claims for lymph-sparing liposuction, a medically necessary and reconstructive surgical procedure, and be reimbursed (a fair amount).
Everything on this website is free of charge. There is no payment option on this web site–anywhere. I use MacAfee as my anti-virus software and all documents are scanned. I am paid by a vendor so feel free to use the information and share it, edit it or add it to your website. I am a reimbursement consultant with over 25-years of experience; the information is detailed and supported by research and feedback from both doctors and patients. Before you invest in a Patient Advocate spend an hour or two downloading and reading the information on this website. It represents over 800 hours of research (in 2020 alone). It includes strategies, sample forms and contracts, research, appeal tips and a detailed Reimbursement Guidebook with explanations of terms and concepts.
I recommend first downloading the Liposuction for Lipedema Checklist and that may be all you need to know (and do) to be reimbursed for liposuction for lipedema. The document is short but the work involved will take many hours to review and assemble.
Click on Latest Info tab for a list of all our Posts. There is a lot there! These can also be searched by Category or Keyword using the Search window on the top right.
Our Reimbursement Guidebook below, now over 85 pages, includes most of the posts and is available on our Downloads page for free. An Amazon Kindle version is available (exact same content but it will cost you $2.99 [Amazon’s rules not mine] and you can read it on any device).
On September 9, 2020, Karen Herbst presented new ICD-10-CM codes for lipedema and lipolymphedema to the NCHS/CDC committee. If accepted they will be available to use Oct 1, 2021 and become part of the 2022 ICD-10-CM code set. Read about it here; the documents are also available on our Downloads page.
A lot of people have asked us what is our mission? Why are we doing this?** Our primary goal is to increase medical carrier reimbursement for liposuction for lipedema nationwide. Toward that goal I offer five components:
- Contact Providers, researchers, patients, associations, and insurance companies.
- Gather information and research.
- Disseminate accurate and up-to-date information (related to reimbursement).
- Educate all of the above.
- Provide a specific deliverables (this website and all documents).
I would like to help with the many misconceptions concerning treating lipedema with Lymph-Sparing Liposuction. This is considered reconstructive surgery, medically necessary, and reimbursed by some (but not all) insurance carriers. Always be ready to appeal your case. Most will be denied at least once.
While strictly cosmetic liposuction (to improve appearance) is not reimbursed, reconstructive liposuction (for lipedema, removal of a lipoma, and in conjunction with a panniculectomy) is paid under very strict documentation and patient requirements and guidelines. In the Guidebook I include a Provider/Patient Checklist of actions to help you win approval.
Lipedema is frequently misdiagnosed or wrongly diagnosed as lifestyle-induced obesity or lymphedema. It is estimated that as many 11% of women or 17 million have lipedema–and most are told they are simply obese. This website won’t go into detail into Lipedema or include photographs–there are plenty of other sites for that. It is focused on the coding, documentation, strategy, and research needed to get pre-authorization and win appeals for liposuction for lipedema. I know it’s a lot of information and much of it will be new to you, but hang in there. You may have to read some documents multiple times.
Good Luck
Jeffrey Restuccio, CPC, COC, MBA
Updated January 25, 2021
** A lot of people ask me why my interest in Lipedema. This is a professionally-funded site. In other words, I am being paid to make information, worth thousands, available free to anyone who wants it–and use any way you want (you can cut- and-paste documents or use the information on your website or blog). I am a reimbursement expert with many years of experience getting claims paid. More information on my background is on the About Us page.