The American Society of Plastic Surgeons has developed a series of papers outlining the Society's position on recommended insurance coverage criteria for third-party payer coverage.
These papers are designed to assist third-party payers in addressing reimbursement issues for various "gray area" plastic surgery procedures, those that could be considered either cosmetic or reconstructive.
Current Insurance Coverage Criteria Recommendations
- Autologous Fat Grafting to the Breast (2015)
- Reduction Mammaplasty (2011)
- Reduction Mammaplasty Sample Appeal Letter (2011)
Archived Insurance Coverage Criteria Recommendations*
- Abdominal & Panniculectomy Unrelated to Obesity or Massive Weight Loss (2007)
- Blepharoplasty (2007)
- Surgical Treatment of Skin Redundancy for Obese & Massive Weight Loss Patients (2007)
- Nasal Surgery (2006)
- Ear Deformity: Prominent Ears (2005)
- Breast Reconstruction Following Diagnosis & Treatment for Breast Cancer (2004)
- Breast Reconstruction for Deformities Unrelated to Cancer Treatment (2004)
- Prophylactic Mastectomy (2003)
- Skin Lesions (2003)
- Gynecomastia (2002)
*Archived recommendations are not accessible to the public, but ASPS members may download and view the documents after entering their ASPS login credentials.