Cigna Medical Coverage Policy: Surgical Treatments for Lymphedema and Lipedema

This is 25 pages, updated 9/15/2020 and a formal denial policy. There are references to 85 research papers in the reference list. You can read it before you submit your claim–so you know what you could expect–or wait until your first appeal.

Carrier Denial Reason: No National USA Standards For Lipedema And Liposuction

Below is a review of the current international guidelines for lipedema and their recommendations for liposuction. As of Sep 2020, we do not have a USA standard. I know several lipedema experts are working on one but it may be at least six months before we see one presented.The Buso… Continue reading

Requesting the Carrier Pay an Out-Of-Network Surgeon as In-Network

What you must do: We are assuming that you’ve passed the approval hurdle, the surgery has been deemed to be reconstructive and medically necessary and not cosmetic. You have also discussed the number of procedures required (typically at least two, depending on severity). Often the insurance carrier will assign the… Continue reading

Cosmetic VERSUS Reconstructive Liposuction

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

Liposuction for Lipedema Research Highlights (8)

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