The attached spreadsheet is for the patient to maintain all the information they need to be reimbursed. It is imperative that the patient has everything in order before they contact the insurance company for the pre-authorization. The more documentation you have, and the better it supports the procedure as reconstructive… Continue reading
After accumulating hundreds of pages of information on how to be reimbursed for liposuction for lipedema, we now has the issue of “how insurance-friendly” is your chosen surgeon.” There is additional information on all of the specific terms in this article on this website. If you download the one-page checklist… Continue reading
Recommended updates to the lipedema.org coding page Aug 19 2020. https://www.lipedema.org/about-lipedema The information on the www.lipedema.org web page (Aug 19, 2020) is confusing and incorrect. Please see the update below. On June 12, 2020 an ICD-10-CM evaluation committee, headed by Dr. Karen Herbst with support from the American Vein and… Continue reading
Yes, this is the same Guidebook that is on Amazon.com. It is provided here at no cost to you and in .DOC format so you can copy-and-paste any of into your pre-authorization or appeal document. I am updating it every 4-6 weeks. My goal is to update this document every… Continue reading
This varies by insurance company. Each one is different but common periods are 90, 120, 180, and 365 days. If the insurance company does not receive your claim within their period it will be denied and you will be responsible for all charges. This has nothing to do with any… Continue reading
Lipedema and Lipolymphedema [Update September 9, 2020 Karen Herbst presented the new codes to the NCHS/CDC committee. The meeting went well and after a public review period it will be determined in early 2021 if they will move forward with the new codes.] Lipedema, initially described at the Mayo clinic… Continue reading
I’ve been contacting researchers,surgeons, associations, and patients for months and providing up-to-date and accurate information on how to be reimbursed by insurance companies for liposuction for lipedema. The question I get most often is, “How can I help? What specifically do you want me to do?” So here is the… Continue reading
I am preparing a submission for the addition of specific lipedema codes for publication on Oct. 1 2021 to The National Center for Health Statistics (NCHS). Specific lipedema codes are needed for identification, tracking, and research. There are two due dates for feedback: June 12, 2020 and then September 2020…. Continue reading
Below is a list of terms, phrasing and supporting research you can include in your pre-authorization or appeal documentation package as appropriate: Medically effective FDA approved equipment Conclusions…the effect of the intervention on health outcomes Make argument …that measurement(s) or alteration affects health outcomes Safe or effective Exceeding the outcome… Continue reading
The most recent Excel version of the checklist is above. 1 Liposuction for Lipedema Reimbursement CHECKLIST. Asterisk * [right] means additional information is available on www.lipoforlipedemareimbursement.com [December 2, 2020] Check website for updates.2 Make a decision for surgery (in the future). [Website www.lipoforlipedemareimbursement.com]3 Review your insurance policy for coverage information…. Continue reading
Currently (MAR 2020), There is no ICD-10-CM diagnosis code in the United States specific to Lipedema. After reviewing this issue, I have identified three ICD-10-CM codes used in the USA for lipedema. Each one has its pros and cons. The three are: R60.9 Edema Q82.0 Familial Hereditary Edema E88.2: Adiposis… Continue reading