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
Below is a sample letter to request a Reimbursement Policy Evaluation for Liposuction for Lipedema. While this example is Noridian Medicare, it can be used for any carrier. Just change the name and if they have any information in their manual I would add that as well. There are a… 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
There is no national database that tracks all complications for all procedures so any number is an estimate. Deaths may be reported to state agencies but the number of cases done is not reported anywhere so while we may have an estimated numerator, there is no accurate denominator, especially since… Continue reading
This is another one-page graphic–everything on one page with concepts, specific items, and their relationship to one another all on one page. It is very useful for group meetings with high-level management–as well as clinical people. The detail is in my Reimbursement Guidebook; a one-page checklist is also available on… Continue reading
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
The information below would be of most interest to those performing liposuction for lipedema, and in particular those who are interested in obtaining carrier reimbursement for the procedure. Please see my other posts concerning reconstructive versus cosmetic and medical necessity for coverage of those important reimbursement issues. The information below… Continue reading
After several months feedback has been to simplify, simply, and SIMPLIFY! I’ve updated the checklist (Aug 14, 2020). I now have a one-page concise version plus a longer, three-page version. The guidebook will be updated shortly in Aug 2020 and is now over 50 pages. While personally I think all… Continue reading
Recently Providers and researchers have asked me how they can help. Here is a list of questions. Don’t feel like you need to answer them all. Which ICD-10 code do they use for lipedema: R60.9, Edema, Q82.0 Familial Hereditary Edema, or E88.2: Adiposis dolorosa; Lipomatosis dolorosa (Dercum’s disease)? Do they… Continue reading
I encourage all doctors and associations to add, at the very least, the following single sentence to their website or blog (patients please share this with everyone who cares as well as your doctor; it can make the difference between reimbursement and a denial): There are two kinds of liposuction:… Continue reading
Lipedema: A Call to Action! (Buso G et al., 2019) Authors: Giacomo Buso, Michele Depairon, Didier Tomson, Wassim Raffoul, Roberto Vettor and Lucia Mazzolai, Wiley Online Library Obesity, 27, 10, (1567-1576), (2019). Below is an excerpt of the most salient parts in regard to reimbursement for liposuction for lipedema. For patients with minimal or no improvement following conservative… Continue reading
The following is in the conclusion of Dr Bertsch’s four-part series on Lipedema Myths. Bertsch T et al. Lipedema – Myths … Phlebologie 2019; 48: 47–56 47 Some of the criteria below have not been well-defined. There is no international standard or US standard for performing liposuction for lipedema. One… Continue reading
Lymph-Sparing Liposuction – Marketing Ploy or Medically Accurate Phrase? Our medical carrier reimbursement project for liposuction for lipedema is marketing something: that liposuction for lipedema is reconstructive and medically necessary. Toward that goal we want the very best verbiage that helps us win the most cases. I believe we need… 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