Panniculectomy

This policy covers panniculectomy to remove excess abdominal adipose tissue and redundant skin and to tighten/repair the anterior abdominal wall when performed to restore or improve function in patients with a panniculus hanging below the pubis that causes non‑healing ulcers, chronic maceration/necrosis, recurrent skin infections or intertrigo, or limits physical activity/ADLs, including selected post–weight‑loss cases. Coverage requires documented failure of ≥3 months of appropriate medical therapy and good hygiene, weight‑loss–related cases require stable weight (≥6 months and, if post‑bariatric, typically ≥18 months post‑op), and purely cosmetic abdominoplasty or procedures without documented functional impairment are not covered.

"Panniculus hangs below the level of the pubis, documented by photographs."

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