Why Your Lipedema Surgery May Have Been Considered Cosmetic

It could be the CPT code used in your prior auth

We often discuss the medical necessity of lipedema treatment and how insurer approval hinges on meticulous documentation and persistence through preauthorization and appeals.

Equally vital is using the correct ICD‑10 and CPT codes to distinguish reconstructive lipedema surgery from cosmetic liposuction, as insurers often default to cosmetic coding to deny claims.

The CPT code 15879: Suction assisted lipectomy; lower extremity is a code designated for cosmetic liposuction.

Below is a detailed look at why CPT code 15879 often leads to outright denials (both by Medicare and commercial payers) and exactly what you can do to correct the problem.