Liposuction for Lipedema

This policy covers liposuction for clinically diagnosed lipedema in patients with symptomatic, typically bilateral and symmetrical disproportionate adipose deposition (often with pain/tenderness, subcutaneous nodules, negative Stemmer sign, easy bruising, heaviness) that causes functional impairment or limits activities of daily living. Coverage is limited to those who have failed adequate conservative management (e.g., compression therapy, manual lymphatic drainage, and documented physician‑supervised weight‑loss efforts with medical records/photographic documentation of refractory disease), and liposuction is not curative, may require multiple sessions, has limited nonrandomized evidence, and is considered investigational for chronic lipedema outside research contexts.

"Liposuction for treatment of lipedema when there is physical functional impairment (difficulty ambulating or performing activities of daily living)."