🚀 Switch to a Smarter Revenue Cycle
Plastic Surgery Billing Service
Plastic surgery billing is uniquely complex—spanning both medical and cosmetic procedures, each requiring distinct documentation and coding accuracy. From reconstructive surgeries to elective enhancements, every treatment demands precise CPT codes and payer-specific compliance to avoid denials.
We provide tailored billing solutions for plastic surgeons that maximize revenue, reduce denials, and accelerate reimbursements. Our certified coders understand the intricacies of plastic surgery billing and ensure your claims are clean, timely, and fully compliant with insurance policies.
🧠 Why Specialized Billing Matters in Plastic Surgery
Unlike general medical billing, plastic surgery practices often face blurred lines between medically necessary and elective procedures. Without expert billing, claims can be rejected or underpaid. Our team ensures accurate documentation and coding to distinguish covered procedures from non-covered ones.
We manage the entire revenue cycle—from pre-authorization to claim submission, follow-ups, and payment reconciliation—so you can focus on patient care, not paperwork.
🔑 Key Features of Our Plastic Surgery Billing Services
✅ Accurate Coding for Reconstructive and Cosmetic Procedures
✅ Pre-Authorization and Eligibility Verification
✅ HIPAA-Compliant Billing Workflows
✅ Denial Management & Appeals
✅ EHR/EMR Integration Support
📊 Sample Procedure Codes & Billing Notes
| Procedure | CPT Code | Coverage Type | Notes |
|---|---|---|---|
| Breast Reconstruction | 19357 | Medically Necessary | Requires documentation of mastectomy |
| Rhinoplasty (Deviated Septum) | 30465 | Medically Necessary | Covered if breathing issues are documented |
| Facelift (Cosmetic) | 15824 | Not Covered | Typically self-pay; ensure proper patient notice |
| Liposuction | 15877 | Cosmetic/Varies | May be covered post-trauma or for lymphedema |
| Skin Grafts | 15100 | Covered | Must include diagnosis codes for burns/injuries |
⚙️ How Our Process Works
We take a structured approach to your billing process:
Patient Eligibility & Pre-Authorization
We verify insurance coverage for reconstructive procedures and assist with pre-authorization documentation.Accurate Medical Coding
Our certified coders assign the correct CPT, ICD-10, and modifier codes based on your clinical notes.Clean Claim Submission
Claims are submitted promptly with all required documentation to avoid delays.AR Follow-up & Denial Management
We follow up aggressively on delayed or denied claims and file appeals when necessary.Reporting & Revenue Optimization
Monthly reports help track your revenue cycle, missed opportunities, and claim trends.
🔍 Understanding Insurance Coverage in Plastic Surgery
One of the biggest hurdles in plastic surgery billing is determining insurance eligibility. While most cosmetic procedures are not covered, certain reconstructive surgeries may qualify for insurance reimbursement—but only with detailed and accurate documentation. Our billing specialists work with your staff to verify coverage before the procedure, reducing surprises and improving transparency for both you and your patients.
📄 Documentation Support for Medical Necessity
Payers often require thorough documentation to prove the medical necessity of a procedure. We help you gather and present all necessary materials—clinical notes, photographs, and referral letters—to meet payer criteria. This not only improves your approval rates but also ensures your practice stays compliant with ever-changing billing rules.
🔁 Handling Rejections and Appeals
Insurance rejections are common in plastic surgery due to vague codes or insufficient information. Our team monitors all claim statuses in real time and takes prompt action on any denials or rejections. We also manage the appeals process on your behalf, compiling robust supporting documentation to reverse negative decisions and recover lost revenue.
🧾 Transparent Pricing for Self-Pay Patients
Many plastic surgery practices rely heavily on self-pay patients. We help you build transparent and easy-to-understand billing structures for out-of-pocket procedures. From upfront cost estimates to installment options, we support you in delivering a professional and patient-friendly payment experience.
🌎 Scalable Billing for Growing Practices
Whether you’re a solo surgeon or part of a growing aesthetic center, our billing services scale with your needs. From managing increased patient volume to handling new procedure codes or adding providers, our flexible infrastructure ensures your billing keeps pace with your business growth. We also integrate easily with your EHR or PM systems for smooth operations.
MyMedicalBillingService.com is a trusted medical billing company managing everything from coding to claims and payment follow-ups. We specialize in resolving billing challenges for practices of all sizes and specialties, letting you focus on exceptional patient care while we handle the complexities of your revenue cycle.
