They say everyone loves a winner, but Costhetics has a special place in its heart for losers.
We are particularly fond of big losers, those people who have achieved a significant drop in body fat with diet, exercise, and/or medical intervention. Bravo, mates, bravo!
In addition to our love and admiration, we’ve got some important news to share if your weight loss success left you with excess, sagging skin and some fat, and you are considering a tummy tuck. You may be eligible for a small Medicare rebate if you meet certain weight loss criteria.
An understanding of MBS codes for tummy tuck surgery can help you unlock all sorts of financial savings. Before we begin sorting through the criteria you need to meet for Medicare item numbers for tummy tuck surgery, let’s begin with the requirements these codes have in common.
Will Medicare Pay for My Tummy Tuck? Yes, If…
Looking for ‘tummy tuck’ or ‘abdominoplasty’ in the MBS Online Medicare Benefits Schedule? You won’t find them. Instead, you’ll find codes related to lipectomy, a medical term for the removal of subcutaneous fatty tissue from various parts of the body, including the abdomen.
To receive any rebate in this category, you will need to demonstrate that:
- Your weight loss was significant (defined as a minimum of five BMI units*)
- You have maintained that weight loss for at least six months prior to seeking surgery.
- Surgery is not intended as a primary bariatric procedure for weight loss
- The surgery is for therapeutic, not cosmetic purposes
When is the removal of excess skin a matter of good health? When:
- Excess sweat and bacteria puddle between skin folds
- Skin irritations including rashes and painful sores appear that are not responsive to treatment
- A tear in the abdominal wall is aggravating a hernia
Your surgeon and support team may be helpful in guiding you through the number crunch of Medicare benefits for tummy tucks.
*An important note: if your weight loss is related to childbirth, your baby’s birth weight and the weight of other products of conception are not included in the establishment of the patient’s baseline weight measurement.
Tummy Tuck: 5 MBS Codes Every Big Loser Should Know
Body contouring is an amazing gift to big losers. Resolving issues that diet and exercise never could, procedures such as abdominoplasty, thigh lift, and brachioplasty (arm lift) relieve a variety of painful physical problems related to deflated, hanging skin.
The five Medicare item numbers you should look at are:
- 30165 – This code is for a lipectomy and wedge excision of the excess non-abdominal skin and fat apron that hangs over the lower abdomen after weight loss.
- 30168 – This code is for lipectomy and wedge excision of excess non-abdominal skin and fat on arms, legs, or other skin areas.
- 30171 – This code is for lipectomy and wedge excision of excess non-abdominal skin and fat on the inner thighs and arms.
- 30177 – This code is for lipectomy, and the excision of skin and subcutaneous tissue in conjunction with a radical abdominoplasty for a full tummy tuck or extended tummy tuck.
- 30179 – This code is for a circumferential lipectomy to contour the trunk and remove excess skin.
Medicare rebates can mean thousands of dollars in financial savings to patients and can open up the door to restorative procedures that can truly be called life changing. How can Medicare help you get the surgery you want and need? They already have! Visit the MBS website for an eye-opening tour. Still overwhelmed? Costhetics is always in favour of talking to an expert, so why not sit down with a doctor listed on Costhetics to learn more.