(2023) How To Bill The Abdominoplasty CPT Codes
The abdominoplasty CPT codes are CPT 15830, CPT 15847, CPT 15876, and CPT 15877. Below you can find an explanation of the CPT codes for abdominoplasty CPT codes and the corresponding billing guidelines.
What Is Abdominoplasty?
Abdominoplasty is also known as an ‘tummy tuck’. Conventional and modified tummy tucks are frequently performed on patients with mild to irregularities, loose skin, and weak abdominal muscles.
These procedures involve tightening the muscles above the belly button and creating a belly button. Tummy tucks are done purely for cosmetic purposes to address concerns like sagging skin, stretched muscles, stretch marks, and scars.
Tummy tucks can be done for reasons. Involve removing excess skin and fat from the area between the pubic region and the belly button or higher. A new belly button may also be created, along with tightening of the muscles if there is a separation.
The Four Abdominoplasty CPT Codes
There are four CPT codes that can be used to bill abdominoplasty. Below we described these procedures.
CPT 15830
The CPT code 15830 represents an Abdominoplasty with a full tummy tuck commonly used to improve the appearance of the lower abdomen.
CPT 15847
The CPT code 15847 is an add-on code used for a body lift, also known as belt lipectomy or circumferential abdominoplasty. It should be used in combination with CPT 15830.
CPT 15876
The 15847 CPT code is another abdominoplasty procedure and is billed for removing fat tissue with a suction method from the patient’s neck and head area.
CPT 15877
The CPT code 15877 can be used for removing fat from sections of the trunk.
CPT 17999
If one of the codes above does not cover the abdominoplasty procedure, you can use CPT 17999 for an unlisted skin procedure.
Billing guidelines
If an abdominoplasty is performed for reasons and there are no functional concerns, it may not be covered by insurance unless explicitly stated in the patient’s policy.
However, the cost of a panniculectomy (coded as CPT 15830) could potentially be covered by insurance.
It’s essential to adhere to all rules and guidelines when submitting claims using CPT code 15847. This code should be used alongside primary procedure 15830.
Make sure to fulfill all documentation requirements to support your claim and prevent denials or audits as Centers for Medicare & Medicaid Services advised.
Example 1
A woman who is 42 years old has successfully managed to lose weight through a rounded exercise routine. Despite trying methods, she still experiences discomfort and low self-confidence due to the skin and tissue around her stomach area. Upon seeking advice from a certified plastic surgeon, she underwent a procedure to eliminate the surplus skin and attain a more streamlined and defined abdomen.
The specific CPT code utilized for this procedure is Abdominoplasty CPT code 15847.
Example 2
The woman, who is 42 years old, is a mother with experience in giving birth to three children. She has a history of gaining weight during pregnancy and successfully losing it after delivery.
However, she is unsatisfied with the sagging skin and stubborn fat in the area below her belly button. Additionally, she mentions having diastasis recti (muscle separation) in her abdomen due to. While there are no hernias or other abdominal conditions, she still has excess skin and subcutaneous fat in her lower abdomen.
To find relief, she decided to undergo a procedure (CPT code; 15847). This surgical intervention involves making an incision in the abdomen and repositioning and tightening the abdominal muscles. The procedure is performed under anesthesia. Typically takes about three hours to complete.
A patient who is getting older decides to have a procedure done to tighten the muscles in their abdomen and remove any skin and tissue causing cosmetic or functional concerns.
In the case of a patient who has struggled with obesity in the past, they opt for liposuction to eliminate both skin and fat. This treatment may involve a combination of liposuction tightening the rectus abdominis muscles, and repositioning the umbilicus (belly button).
Sources
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=58573&ver=4
- https://emedicine.medscape.com/article/1271693-overview
- https://www.plasticsurgery.org/cosmetic-procedures/tummy-tuck
