Medicare AdvantageCoverageMedium impact
MA11.073f, Panniculectomy, Abdominoplasty, Abdominal Lipectomy, and Other Excisions of Redundant Skin
Independence Blue Cross·Plastic Surgery, General Surgery·Medical Policy
Effective date
Dec 29, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage updated the medical necessity criteria for panniculectomy, abdominoplasty, and abdominal lipectomy procedures. This affects coverage determination and prior authorization requirements for plastic surgery procedures involving removal of redundant abdominal skin.
Action Required
By December 29, 2025: Billing team must review updated medical necessity criteria for panniculectomy and abdominoplasty procedures. Update prior authorization documentation requirements in billing system. Ensure providers document medical necessity according to new criteria before submitting claims to Medicare Advantage plans.