Billing for plastic & reconstructive surgery is not general billing with a different code set. Reconstructive versus cosmetic determination, which decides whether there is a claim at all.
The functional-impairment documentation is the entire coverage argument, and photographs are frequently required before authorization.
At a glance
What drives the coding
Reconstructive versus cosmetic determination, which decides whether there is a claim at all.
What drives the payer behavior
The functional-impairment documentation is the entire coverage argument, and photographs are frequently required before authorization.
Coding
Assigned by certified coders from your documentation.
Reporting
Denials segmented by reason, payer, and provider.
Where plastic & reconstructive surgery claims actually fail
- Functional impairment not documented
- Procedure deemed cosmetic on review
- Prior authorization obtained for the wrong code
How we work it
We code from what your record documents and query you when it does not support a code, which in plastic & reconstructive surgery is where most of the avoidable exposure sits.
Denials are worked by cause rather than in queue order, so the same failure stops recurring instead of being re-worked every month.
We work the claims. You practice medicine.
Coding, claim submission, denial management, and A/R follow-up — with nothing left for your front desk to chase.
View pricingHow It Works
Review
We look at your current plastic & reconstructive surgery denials and aging.
Scope
A written scope and price before any work starts.
Transition
Coding and submission move across without a gap.
Report
Denial causes reported monthly, segmented by payer.
Plastic & Reconstructive Surgery — Frequently Asked Questions
Do you have coders who know plastic & reconstructive surgery?
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Yes. All coding is performed by certified coders, and specialty assignment is deliberate — reconstructive versus cosmetic determination, which decides whether there is a claim at all.
Do you guarantee we will collect more?
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No, and nobody honestly can. Payment is decided by the payer. What we commit to is the process and the six numbers we report, which you can check against your own system.
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