Filing Tips Sep 28 2020

These are additional filing tips in addition to the Reimbursement Checklist. 0.1 Intro   In general I have short, one or two-page checklists and then much longer and detailed explainations of nearly everything. Work the checklists first and then look to the Guidebook or the Policy Evaluation Document for more… Continue reading

Gotcha! List for Liposuction for Lipedema Reimbursement

Below is a valuable list of Gotchas!, Catch-22, Carrier-Specific Rules, and confusing, ambiguous, and contradictory Carrier guidelines and policies. This is kind of advanced but worth your time–especially if denied. I would argue it’s best to review before you file your claim. 1 WHAT IS A GOTCHA! ? A Gotcha… Continue reading

Frequently Asked Questions (FAQ)

Q: Isn’t Lipedema the same as Obesity? No, it is a condition in which there is a pathological deposition of fatty tissue, usually below the waist, leading to progressive leg enlargement. Lipedema is often misdiagnosed as simply obesity or lymphedema. There is no cure for lipedema and it does not… Continue reading

Denial Reason: Patient Does Not Have Lipedema

Always get the background of the Expert Opinion Physician. Typically it will be a Plastic Surgeon. If the doctor is not a recognized name in liposuction for lipedema or lipedema diagnosis, work to determine their level of expertise. Expert opinion is not qualified. Propose that the expert is not a… Continue reading

Correction to the Lipedema.org ICD-10 Coding Information

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

New ICD-10-CM code submission for Lipedema to NCHS/CDC June 12 2020

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

June is National Lipedema Awareness Month

FOR IMMEDIATE RELEASE June is National Lipedema Awareness Month Memphis TN, June 12, 2020 Lipedema is often misdiagnosed as obesity, edema, or lymphedema. While all can be present with lipedema, it is a separate condition. When lymphedema occurs with lipedema it’s known as lipolymphedema, a secondary lymphedema. To accurately diagnose… Continue reading

Request for Feedback on Lipedema ICD-10-CM Codes for NCHS

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