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ASPS Positions on Recommended Insurance Coverage Criteria

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.

Recommended Insurance Coverage Criteria

Blepharoplasty (03/07)  PDF File
Abdominoplasty and Panniculectomy Unrelated to Obesity or Massive Weight Loss (01/07)  PDF File
Nasal Surgery (07/06)  PDF File
Surgical Treatment of Skin Redundancy for Obese and Massive Weight Loss Patients (01/07)  PDF File
Ear Deformity: Prominent Ears (12/05)  PDF File
Breast Reconstruction Following Diagnosis and Treatment for Breast Cancer (09/04)  PDF File
Breast Reconstruction for Deformities Unrelated to Cancer Treatment Insurance Coverage Criteria (09/04)  PDF File
Prophylactic Mastectomy Coverage Criteria (03/03)  PDF File
Skin Lesions (03/03)  PDF File
Gynecomastia (03/02)  PDF File
Reduction Mammaplasty (03/02)  PDF File
The Health Burden of Breast Hypertrophy (11/01)  PDF File
Breast Reduction Clinical Outcome Study (05/01)  PDF File
Reduction Mammaplasty Sample Appeal Letter  Word File