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Septoplasty
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Featured Answer
3 UpVoted this answer
Can or Should? Insurance may pay for a deviated nasal septum that causes significant breathing problems. Most insurances do not pay for cosmetic surgery. Submitting a bill for a cosmetic operation and calling it functional is fraud. Also, many companies if they pay for a deviated nasal septum the amount is about $600- 700. Most cosmetic operations are much more than this. Speak to your surgeon in advance regarding payment options.
2 UpVoted this answer
Correcting the crooked nose and deviated septum can be considered a functional rhinoplasty if the nasal airway is compromised. Addressing these components would improve the appearance of the nose as well as the function, and therefore if this is all that is desired, an insurance based rhinoplasty may be appropriate. If other issues are to be addressed, a cosmetic component may be considered for the rhinoplasty (nose job).
2 UpVoted this answer
He might do that but his ethics would be questioned.
Why are you getting nasal surgery? Every Caucasian has a "slightly deviated septum". If you have difficulty in breathing than septal work may be indicated. There are other factors that must be evaluated besides the septum.
If it esthetics of your nose that is of concern and your goal being improvement in appearance then billing for a Septoplasty as payment in full is definitely unethical and you must be prepared to pay.
I would suggest a second or even a third opinion from a board certified Ear, Nose and Throat Specialist.
Most of all be true to yourself!!!!!!!
Why are you getting nasal surgery? Every Caucasian has a "slightly deviated septum". If you have difficulty in breathing than septal work may be indicated. There are other factors that must be evaluated besides the septum.
If it esthetics of your nose that is of concern and your goal being improvement in appearance then billing for a Septoplasty as payment in full is definitely unethical and you must be prepared to pay.
I would suggest a second or even a third opinion from a board certified Ear, Nose and Throat Specialist.
Most of all be true to yourself!!!!!!!
1 UpVoted this answer
Thank you for writing to me.
Health Insurances these days generally will pay for the functional part of the surgery but they deny the aesthetic part. Depending on which state you live in things may be different. Best would be for you to go for consultation with a Board Certified Plastic Surgeon. He/she will review your history and examine you. Based on the results of this evaluation he/she will be able apply for pre-authorization and and receive a response from your Insrance Company.
I hope this has been of some help to you.
Health Insurances these days generally will pay for the functional part of the surgery but they deny the aesthetic part. Depending on which state you live in things may be different. Best would be for you to go for consultation with a Board Certified Plastic Surgeon. He/she will review your history and examine you. Based on the results of this evaluation he/she will be able apply for pre-authorization and and receive a response from your Insrance Company.
I hope this has been of some help to you.
1 UpVoted this answer
All insurance work which is legitimately found on physical exam and documented in the note with the proper codes and submitted to insurance with the proper codes can certainly be billed to insurance if it is pre-certified and found medically necessary. If there is additional cosmetic work which needs to be done this can be performed simultaneously and the cosmetic fee paid to the surgeon. Best of luck in your endeavors.
1 UpVoted this answer
As a Board-Certified Plastic Surgeon, it would be considered unethical to do this. Unfortunately, it is a very common source of insurance fraud. The majority of individuals may have some type of septal deviation or irregularity, but the true question is whether or not this causes a functional impairment. The cosmetic portion of the procedure should always be considered a separate part and would not fall under insurance coverage.
1 UpVoted this answer
If septoplasty (straightening and/or removing obstructing parts of the septum) is done for functional purposes (not all deviated septums interfere with breathing), it is covered by insurance. That means that the septoplasty and the time in the operating room devoted to the septoplasty would be billed to the patient's insurance by the doctor, the anesthesiologist and the facility. The time to do the cosmetic portion of the external rhinoplasty is separately billed by the anesthesiologist, the facility and the plastic surgeon. The times are documented in the anesthesia record and the operative report as a routine matter, so there is clarity for the insurance company as to what portion of the time was due to the reconstructive vs. the cosmetic parts of the procedure.