Panniculectomy Surgery (for North Carolina Only)
Policy governs coverage guidance for panniculectomy surgery for UnitedHealthcare members in North Carolina and defers to the North Carolina Medicaid Clinical Coverage Policy Reconstructive and Cosmetic Surgery (1-O-1) for clinical coverage criteria. It lists applicable CPT procedure codes and notes state-specific fee-schedule exclusions.
Title changed from 'Panniculectomy and Body Contouring Procedures (for North Carolina Only)' to 'Panniculectomy Surgery (for North Carolina Only)'.
CPT codes 15832-15839 and 15876 removed from Applicable Codes list.
Updated FDA section to reflect most current information.
Archived previous policy version CSNC.MP.014.06.
Coverage Summary & Rationale
This policy governs coverage guidance for panniculectomy surgery for UnitedHealthcare members in North Carolina and defers to the North Carolina Medicaid Clinical Coverage Policy, Reconstructive and Cosmetic Surgery (1-O-1) for clinical coverage criteria determining medical necessity for reconstructive versus cosmetic panniculectomy procedures. It lists applicable CPT procedure codes and notes state-specific fee-schedule exclusions. Effective Date: November 1, 2025. Policy Number: CSNC.MP.014.07.
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