Panniculectomy and Abdominoplasty - (0027)

Cigna covers panniculectomy only when strict criteria are met (pannus at or below the symphysis pubis causing persistent intertriginous dermatitis/cellulitis/ulceration refractory to ≥3 months of medical therapy, a documented functional deficit interfering with activities of daily living with expected functional improvement); abdominoplasty, diastasis recti repair and other cosmetic procedures (including standalone suction‑assisted lipectomy) are considered cosmetic and not medically necessary, and suction lipectomy performed with a medically necessary panniculectomy is incidental and not separately reimbursed. Required documentation includes preoperative photos showing pannus level, records of ≥3 months of specific medical management (hygiene, topical antifungals, topical/systemic corticosteroids and/or antibiotics), clinical documentation of the functional deficit and expected improvement, evidence of weight stability (≥6 months or ≥18 months post‑bariatric surgery with 6 months stable), and appropriate procedure/diagnosis codes.