{"id":363,"date":"2020-09-28T10:41:28","date_gmt":"2020-09-28T10:41:28","guid":{"rendered":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/?p=363"},"modified":"2020-09-28T11:03:15","modified_gmt":"2020-09-28T11:03:15","slug":"denial-reason-patient-does-not-have-lipedema","status":"publish","type":"post","link":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/denial-reason-patient-does-not-have-lipedema\/","title":{"rendered":"Denial Reason: Patient Does Not Have Lipedema"},"content":{"rendered":"\n<p>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.<\/p>\n\n\n\n<p>Expert opinion is not qualified.<\/p>\n\n\n\n<p>Propose that the expert is not a \u201cpeer\u201d in relation to the lipedema experts you\u2019ve consulted with.<\/p>\n\n\n\n<p>Not a published lipedema expert.<\/p>\n\n\n\n<p>Does not have the experience that Dr. Schwartz has (hundreds of operations).<\/p>\n\n\n\n<p>Lipedema is not a rare disease, it is a rarely diagnosed disease (underdiagnosed). See the Lipedema explanation notes.<\/p>\n\n\n\n<p>Provide qualifications of all your providers (e.g., Dr. Iker and Dr. Schwartz).<\/p>\n\n\n\n<p>The xx components of a lipedema diagnosis. I have more on this later in this document<\/p>\n\n\n\n<ol class=\"wp-block-list\" type=\"1\"><li>Stemmer sign negative<\/li><li>Cuffing<\/li><li>Ultrasound<\/li><\/ol>\n\n\n\n<p>Lipedema Stages: Stages 1 to 3 (see information below on stage 4).<\/p>\n\n\n\n<p>Most providers don\u2019t document the type, but there are five types.<\/p>\n\n\n\n<p>See the Word Doc below for more detail.<\/p>\n\n\n\n<div class=\"wp-block-file\"><a href=\"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-content\/uploads\/2020\/09\/Denial-reason-patient-does-not-have-lipedema.docx\">Denial-reason-patient-does-not-have-lipedema<\/a><a href=\"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-content\/uploads\/2020\/09\/Denial-reason-patient-does-not-have-lipedema.docx\" class=\"wp-block-file__button\" download>Download<\/a><\/div>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>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&#8230; <a class=\"continue-reading-link\" href=\"https:\/\/12uh.com\/lipoforlipedemareimbursement\/denial-reason-patient-does-not-have-lipedema\/\"> Continue reading <span class=\"meta-nav\">&rarr; <\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[184,33],"tags":[35,14,36,28,159,167,111,5,99,102,119,6,15,24,16,23,22,26,27],"class_list":["post-363","post","type-post","status-publish","format-standard","hentry","category-insurance-carrier","category-reimbursement","tag-appealing-a-denied-claim","tag-claim-form","tag-cosmetic-surgery-policy","tag-cpt-code","tag-denial-reason","tag-diagnosis","tag-icd-10-codes","tag-lipedema","tag-lipedema-stage-1-stage-2-stage-3","tag-lipedema-stages","tag-lipolymphedema","tag-liposuction","tag-liposuction-reimbursed","tag-medical-insurance-companies","tag-medical-necessity","tag-medical-reimbursement","tag-reconstructive-surgery","tag-reimbursement-policy","tag-tumescent-liposuction"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/posts\/363","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/comments?post=363"}],"version-history":[{"count":3,"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/posts\/363\/revisions"}],"predecessor-version":[{"id":375,"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/posts\/363\/revisions\/375"}],"wp:attachment":[{"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/media?parent=363"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/categories?post=363"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/12uh.com\/lipoforlipedemareimbursement\/wp-json\/wp\/v2\/tags?post=363"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}