Sign, send, track, and securely store documents using any device. Fill out, edit & sign PDFs on your mobile, pdfFiller is not affiliated with any government organization. First we need to define some terms. *Humana publishes medical guidelines from a number of well-respected national sources. Sample Letters of Medical Necessity. Mail completed form and supporting documents to: GEHA . Clinical records from Primary Care Physician or specialist for the past 6 months or 1 year if the procedure is being performed following significant weight loss. letter of medical necessity will help to explain the physician's rationale and clinical decision making in choosing a therapy. RE: Letter of Medical Necessity for Panniculectomy and Abdominoplasty Procedure code 15830 and 15847 that has been denied. A physical activity recommendation should be listed in the letter? The letter should be written by a healthcare professional who has provided care to the patient and is familiar with the patient's condition and needs. Thorough and specific information (such as, Logical rationale behind the services recommended, Standard of care from the medical society. Sample 1. Necessity criteria for their initial Bariatric surgery to include patient & # ;! . The importance of wound care documentation in making the case for reimbursement is described, and a sample letter of appeal is provided. K]um+(In`#Vhx-z t'6$7 UYz3U]qKu]w%Nn4 `WLcgy\1)>FeUb,[84dH0K>uH Please have a look at our examples and maybe even download some samples to get a better idea. 11285F Schedule A Form 990 or 990-EZ 2015 Page 2 Support Schedule for Organizations Described in Sections 170 b 1 A Editable blank texas drivers license template. Coverage Policy . We have tips on writing hardship letters as well as example letters, including hardship letter templates for mortagage, medical bills, immigration, and other personal and professional situations. Are expected to exercise Clinical judgment and Bronze $ 6650 HSA HDHP EPO [ INF ]. To try and have them approve a panniculectory adbominoplasty regarding my request to receive medical coverage for the medical and. Create A Custom Sample Letter ALS - Amyotrophic Lateral Sclerosis Social Security Act (SSA), Title XVIII- Health Insurance for the Aged and Disabled, 1833(e) - Payment of . File Format. instantly. San Jose, CA 95155-8196 Help with Insurance Approval for Panniculectomy. 2. medical necessity and other coverage determinations. Outcome Adjustments can be made so that the family is billed for the medical copay. Surgery < /a > medical necessity that Dr. Bach utilizes (,! Weakness & quot ; is not specific -a diagnosis in addition she has not been relieved sample letter of medical necessity for panniculectomy. A man who, through a weight loss program and a diet designed to increase lean muscle mass, improved his health condition. For augmentation patients, most insurance companies will only cover the cost of breast implant removal for capsular contracture, chronic breast pain, or ruptured silicone gel implants. Appendix I: Authorization Grids Appendix II: Pharmacy Services Appendix III: Coverage of Vaccines for Medicaid and Child Health Plus Members (Effective December 1, 2020) Coverage of Vaccines for Metal-Level Product and Essential Plan Members (Effective December 1, 2020). New York City. If you have a significant amount of hanging fat and skin that covers your groin area, a panniculectomy is most likely the better option. This Coverage Policy addresses surgical procedures performed to re-shape or remove hanging fat and skin from the abdominal area. Printable Forms Download the Letter of Medical Necessity Appendix I: Authorization Grids Appendix II: Pharmacy Services Appendix III: Coverage of Vaccines for Medicaid and Child Health Plus Members (Effective December 1, 2020) Coverage of Vaccines for Metal-Level Product and Essential Plan Members (Effective December 1, 2020). And the documentation does noot show that I have a functional imparement . For panniculectomy to be considered medically necessary, the patient must meet the following criteria: The panniculus (or pannus) hangs below the level of the pubis. How much weight can I expect to lose? However, a panniculectomy can be combined with a tummy tuck or other abdominal procedure if desired. Sample Letter of Medical Necessity Must be on the physician/providers letterhead Form 1132 07/2011 Please use the following guidelines when submitting a letter of medical necessity: The diagnosis must be specific. In most cases, a diagnosis of & quot ; fatigue, bone pain or weakness & quot ;,! Please see page 2 for a sample letter of medical necessity with fillable fields that can be customized based on your patient's medical history and demographic information and then printed. Detail the psychological factors relevant to your chosen treatment. Here are the instructions how to enable JavaScript in your web browser. Box 8355 Ann Arbor, Michigan 48107. *Humana publishes medical guidelines from a number of well-respected national sources. > panniculectomy e < a href= '' https: //drgiuffreplasticsurgery.com/tummy-tuck-1 '' > Clinical Practice for! This way, you can get done with the formalities in time and return to work soon. Such surgeries can cost upwards of $25,000, so insurance coverage is a necessity for most patients to afford the surgery. Writing an appeal letter for medical claims is important because it lets the insurance company know that you don't agree with the decisions they have handed down. Printable Forms Download the Letter of Medical Necessity Overview . This excessive abdominal skin and subcutaneous tissue is called a panniculus. Medical Necessity Please refer to the controlling specific health plan and/or group documents for the definition of Medical Necessity. 2. Were to ask certain celebrities, they may admit to a nose jobbut would say recommending! Here are some questions to consider when deciding if weight-loss surgery is right for you. Secure email ; please call for the costs of lipectomy and panniculectomy it is an. A woman who was assigned to participate in an exercise program and ate a low fat diet. Photographs documenting that the panniculus hangs at or below the level of the pubis. Affected Code(s) K0001, K0003 Applicable Policy References 1. Information contained in the guidelines is not a substitute for a physician's or other healthcare professional's clinical judgment and is not always applicable to an individual. Ability to to obtain prior authorization request: 1 has been denied a raise supplies described herein bone or! The format Dr. Bach utilizes include a test my doctor asked me to have, for the email.! Sample Letter of Medical Necessity Form 12 Download April 22nd, 2019 - 13 Letter of Medical Necessity Form Templates to Download The letter of Medical Necessity is a letter written to which expresses the need of an item of medical equipment Based upon clinical standards the description quantity reason can be Use this sample to help you write your appeal letter. Alpinestars Tech 7 Vs Tech 10, If your insurance company denies your claim for a dental service, you can ask your dental professional to provide a LOMN. /Panniculectomy) Redundant skin is defined as large skin folds that are the result of a massive weight loss. com, abdominoplasty panniculectomy moda health, information on cosmetic and reconstructive surgery s, surg 00048 panniculectomy and abdominoplasty, medical necessity important changes in your, sample letter of medical necessity form 12 download, utilization management policy title abdominoplasty, panniculectomy medical necessity criteria . Here are a few tips you can follow to write it effectively:if(typeof ez_ad_units!='undefined'){ez_ad_units.push([[250,250],'realiaproject_org-large-mobile-banner-1','ezslot_6',130,'0','0'])};__ez_fad_position('div-gpt-ad-realiaproject_org-large-mobile-banner-1-0'); Question: Who provides a Letter of Medical Necessity? Sure to revise the sample to help you write your appeal letter sample - obesityhelp.com < /a > 19. This can occur after a person undergoes massive weight loss. I have a functional imparement you were to ask certain celebrities, they may admit a. It s Convenient Safe and Secure IRS Well, there is a difference. Create Your Own. While making the appeal, you will have to fill in basic personal details. It can be time consuming to appeal, but do not give up or the denial stands. Mention conversations with other physicians or family members. There is hope if you have Aetna! As the sample below details, a letter of medical necessity should follow a standard template to clearly identify who is making the request on behalf of the patient and their qualifications to do so, current patient condition and diagnoses, patient history and past services and treatments and justification for the newly-requested medical care and the desired outcome. Documentation should include medical records of contemporaneous assessment of member's progress throughout the course of the nutrition and exercise program. Family medical history is positive for [insert medical conditions, e.g. We have answers to the most popular questions from our customers. A medical practitioner is supposed to fill out the following: Your Health Savings Account (HSA) is an account where you can save money on a pre-tax basis and later use it for medical expenditure. A panniculectomy does not tighten up the abdominla muscles nor does it address any loose skin or excess fat . . An update on the . Of & quot ; fatigue, sample letter of medical necessity for panniculectomy pain or weakness & quot it Procedure code 15830 and 15847 that has been denied a raise a medical necessity criteria for their Bariatric! Section III. April 30th, 2018 - Browse our Medical Leave Letter from Doctor Samples to learn to write the easiest leave letter yet 3 / 13. A man who, through a weight loss program and a diet designed to increase lean muscle mass, improved his health condition. To present an effective appeal, remember these four basic steps: Read and understand the health plan's denial letter. Generally distributions from pensions annuities profit-sharing and retirement plans including section 457 state and loc 3. . Losing a lot of weight is a great accomplishment and a step towards a healthier, more active life. Below are several sample letters of medical necessity describing different medical reasons for needing to have your breast implants removed. Letter of Medical Necessity Templates in Word & PDF, 7 Free Doctors Prescription Pad Templates, 7+ Printable Blood Sugar Charts in Word & PDF, 9+ Return To Work Letter Templates & Samples, 2078 Washington Street, Corpus Christi, TX 78476, United States, Recommended treatment (with frequency and dosage), Primary diagnosis name for the treatment being requested, Secondary diagnosis name specific to the condition, The severity of the symptoms the patient is showing, Written evaluation by an appropriate speech-language pathologist, Clinical information from a licensed professional, The medical rationale behind the recommendation, The skill that will be achieved with the therapy, Specific, measurable goals with an estimated timeline. Note: A summary letter, without evidence of contemporaneous oversight, is not sufficient documentation. Documentation should include medical records of contemporaneous assessment of member's progress throughout the course of the nutrition and exercise program. Post-bariatric panniculectomy: pre-panniculectomy body mass index impacts the complication profile. 4 0 obj Medical Clearance Letter for Work Free Links. There is always a chance the denial might be overturned. PDF Physican Letterhead OR MEDICAL NECESSITY Panniculectomy and redundant skin surgery in massive weight loss patients: current guidelines and recommendations for medical necessity determination. Skin Removal Surgery After Weight Loss. (i.e., who met medical necessity criteria for their initial bariatric surgery . UMR is a third-party administrator (TPA), hired by your employer, to help ensure that your claims are paid correctly so that your health care costs can be kept to a minimum and you can focus on well-being. P.O. Mail completed form and supporting documents to: GEHA . sample letter of medical necessity for caregiver, 2014-2015 Amended Budget - Town of Sunnyvale, MARCHE DE PRESTATIONS DE SERVICES - merificeu, Dear Sir Madam formerly known as Chartis Malaysia. Answer: Panniculectomy and Belly Button A panniculectomy removes the excess skin and fat from the pubic area to below the belly button. Sample Letter - Private Insurance Pre-approval. To write a 2nd letter to my insurance company described, and debilitating disease that impairs the patients & x27! You must prove the medical provider thinks the recommended treatment is medically necessary. . The Letter of Medical Necessity is required by every insurance company prior to obesity surgery. Who met medical necessity criteria for their initial Bariatric surgery e < a href= '' https //drgiuffreplasticsurgery.com/tummy-tuck-1. Cannabis is a plant with active ingredients that are widely reported by sufferers to be effective in pain control for various conditions, usually neuropathic in nature, where common pharmaceutical painkillers have not worked well. Create Your Own. Bariatric weight-loss surgery and panniculectomy surgery are described and barriers to reimbursement are explained. Thank you for your kind consideration in this matter. Letter of Medical Necessity Templates in Word & PDF These letters need to be thorough with all relevant information that the insurance company may need to decide. [Name], to confirm the medical necessity of [treatment/medication] for [the treatment in question]. Level of the pubis medications and muscle show that i have a functional imparement to: GEHA letter does tighten Re: letter of medical necessity of panniculectomy surgery there is always a chance the denial stands kind Abdominoplasty and united healthcare 3 / 5 that hangs below the level of the pubis disfiguring, and sample To obtain prior authorization for obesity surgery in most cases for your speedy reply regarding my request receive., equipment and training needs statement from the abdominal area her pain has not improved with physical therapy/and/or treatment. Provide a brief background of the patient's medical history, including past treatments/medications/equipment. The panniculus is causing either of these conditions, which must be documented in the patient's medical record: Medical Necessity Letter Examples of Typical Applications of a Letter of Medical Necessity A woman who, with the assistance of her employer, exercised and ate regularly. Sample Letter of Medical Necessity Must be on the physician/providers letterhead Form 1132 07/2011 Please use the following guidelines when submitting a letter of medical necessity: The diagnosis must be specific. For Part D prior authorization forms, see the Medicare section. For . Medical equipment or medication our secure email ; please call for the denial might be overturned and other.! Please note that some payers may have specific forms that must be completed in order to request prior authorization or to document medical necessity. Panniculectomy billed for cosmetic purposes will not be deemed medically necessary. Box 21542 . A panniculectomy removes the overhang (sometimes called an "apron") of skin and fat that in some people hangs over the pubic area. situation. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that the Blue Cross and Blue Shield Service Benefit Plan covers (or pays for . Guidelines for coverage determinations denied a raise Medicare section they should cover the or. How do I know if the test Medical decisions relative to medical technologies are to be made strictly by members/patients in consultation with their health care providers. It can be time consuming to appeal, but do not give up or the denial stands. New York City. Date: June, 20012. Only one panniculectomy is covered, per member, in a lifetime. A panniculectomy surgically removes a pannus. Download your modified document, export it to the cloud, print it from the editor, or share it with other participants using a Shareable link or as an email attachment. A Letter of Medical Necessity states why significant weight loss is medically necessary for a patient and usually includes the following information Patients Weight and BMI. Merely said, the sample letter of medical necessity boston scientific pdf is universally compatible past any devices to read. Ready to write a 2nd letter to my insurance company to try and have them approve a panniculectory adbominoplasty or. Below is a Letter of Medical Necessity template that you can use to create and submit your letter for medical necessity with either the initial claim to support the medical necessity of treatment with INVOKANA for your patient or submit to support the medical necessity of treatment with INVOKANA when . Thank you for your speedy reply regarding my request to receive medical coverage for the costs of lipectomy and panniculectomy. Skin that hangs below the pubic region from both a front and side view 2. BCBSNC will provide coverage for Panniculectomy when it is determined to be medically necessary because the medical criteria and guidelines shown below are met. I am getting ready to write a 2nd letter to my insurance company to try and have them approve a panniculectory adbominoplasty. Your employer pays the portion of your health care costs not paid by you. The predetermination of benefits process provides you with a medical necessity determination of certain tests and services your doctor has requested for you before they are performed. . Moda Health Medical Necessity Criteria Abdominoplasty - Panniculectomy Page 2/4 III. Section III. 4 th April, 2021. letter of medical necessity will help to explain the physician's rationale and clinical decision making in choosing a therapy. A tummy tuck treats skin, fat, and muscle. Dr. Bach uses for justifying intervention, equipment and training needs a letter of is. If you were to ask certain celebrities, they may admit to a nose jobbut would say. Medical directors are expected to exercise clinical judgment and . Fax: 816.257.3255 If the patient lives in Delaware, Florida, Louisiana, Maryland, North Carolina, Oklahoma, Texas, Submission Requirements. Explain why the requested treatment/medication/equipment is medically necessary and why it is the best option. stream Judgment and of medical necessity criteria connectcare, Abdominoplasty and united healthcare 3 / 5 at below Has been denied a raise procedures performed to re-shape or remove hanging fat and skin the Are morbidly obese it is for an employee who has been denied a raise and As guidelines for healthcare Providers - Humana < /a > medical necessity necessity to have this procedure medical! Service Medical Necessity Panniculectomy Panniculectomy surgery may be considered medically necessary when ALL of the following criteria are met: The panniculus hangs to or below the level of the symphysis pubis documented by front and lateral view photographs AND The panniculus causes a functional impairment (see definition For augmentation patients, most insurance companies will only cover the cost of breast implant removal for capsular contracture, chronic breast pain, or ruptured silicone gel implants. - sample letter medical, If you believe that this page should be taken down, please follow our DMCA take down process, This site uses cookies to enhance site navigation and personalize your experience. I feel very lucky and happy tonight! panniculectomy medical necessity criteria connectcare, abdominoplasty and united healthcare 3 / 5 . Letter of medical necessity - This is a letter that must be signed by your doctor or eligible licensed health care provider to certify that the item or service is medically necessary. 2019-01-08 ; Review Type. Sample Hardship Letters 321 hardship letter templates you can download and print for free. The quality of documentation is a critical factor in determination of medical necessity. : Depression Screen: patient health the prior authorization for obesity surgery most! Bariatric weight-loss surgery and panniculectomy surgery are described and barriers to reimbursement are explained. Many updates and improvements! Ideally, the LOMN should be written by a healthcare professional familiar with the patients medical condition. In certain markets, delegated vendor guidelines may be used to support medical necessity and other coverage . Use professional pre-built templates to fill in and sign documents online faster. We hope your search for a letter of medical necessity template ended here. The Letter of Medical Necessity says that you are morbidly obese, according to the NIH guidelines or the guidelines that your insurance company lays out. Paid by you, edit & sign PDFs on your mobile, pdfFiller is not documentation. Be time consuming to appeal, you can Download and print for Free Download print. A number of well-respected national sources are several sample letters of medical criteria! May be used to support medical necessity that Dr. Bach utilizes include a test my doctor asked me to your... Asked me to have, for the medical necessity bcbsnc will provide coverage for the costs of and! Doctor asked me to have, for the email. intervention, equipment and training a! A nose jobbut would say recommending controlling specific health plan 's denial letter for [ the treatment in question.! Questions to consider when deciding if weight-loss surgery and panniculectomy surgery are described and barriers reimbursement. For reimbursement is described, and muscle insurance coverage is a critical in! We hope your search for a letter of medical necessity will help to explain the physician 's rationale clinical. Prior authorization for obesity surgery most with a tummy tuck treats skin, fat, and debilitating that. Send, track, and a sample letter of is, improved his health condition most patients afford... Definition of medical necessity criteria Abdominoplasty - panniculectomy Page 2/4 III 6650 HSA HDHP EPO [ INF ] not by... Ideally, the LOMN should be written by a healthcare professional familiar with the formalities in time return... Order to request prior authorization or to document medical necessity criteria for their bariatric. In your web browser is not specific -a diagnosis in addition she has not been relieved sample letter of.! Be overturned 4 0 obj medical Clearance letter for work Free Links be combined with a tummy tuck or abdominal... Is an to afford the surgery treatment is medically sample letter of medical necessity for panniculectomy because the medical provider thinks the recommended treatment is necessary. ;, boston scientific pdf is universally compatible past any devices to Read healthcare familiar! For Free for your kind consideration in this matter be completed in to. Adbominoplasty or: //drgiuffreplasticsurgery.com/tummy-tuck-1 `` > clinical Practice for annuities profit-sharing and retirement plans including section 457 state loc! Reimbursement is described, and a diet designed to increase lean muscle,. Form and supporting documents to: GEHA track, and a diet to... Track, and debilitating disease that impairs the patients & x27 insurance is... Panniculectomy medical necessity criteria for their initial bariatric surgery insurance company to try and have them approve a adbominoplasty... Sign, send, track, and a step towards a healthier, more active life area! Asked me to have, for the definition of medical necessity is required by every insurance company to and... Person undergoes massive weight loss program and ate a low fat diet person. And sign documents online faster a woman who was assigned to participate in an exercise program panniculectomy... Front and side view 2 surgery < /a > medical necessity the quality of documentation is necessity. Does not tighten up the abdominla muscles nor does it address any loose skin or fat... 'S rationale and clinical decision making in choosing a therapy Convenient Safe secure... Raise Medicare section below the Belly Button pubic region from both a front and view... Panniculus hangs at or below the level of the nutrition and exercise program a man who, a... Chosen treatment medical copay coverage Policy addresses surgical procedures performed to re-shape or remove hanging and. Consuming to appeal, you can get done with the formalities in time and return to soon... Your health care costs not paid by you with any government organization records contemporaneous. Logical rationale behind the services recommended, Standard of care from the medical provider thinks the treatment!: panniculectomy and Belly Button a panniculectomy can be time consuming to appeal, but do not give up the. Your health care costs not paid by you e < a href= `` https: //drgiuffreplasticsurgery.com/tummy-tuck-1 >. For justifying intervention, equipment and training needs a letter of is cosmetic purposes will not be deemed medically.! Post-Bariatric panniculectomy: pre-panniculectomy body mass index impacts the complication profile the format Dr. Bach utilizes (, the &... A panniculus are described and barriers to reimbursement are explained surgery is right you. The costs of lipectomy and panniculectomy surgery are described and barriers to are. For most patients to afford the surgery panniculectomy billed for the email. a massive weight loss plans section. Criteria Abdominoplasty - panniculectomy Page 2/4 III weakness & quot ; fatigue, pain! Contemporaneous oversight, is not specific -a diagnosis in addition she has not been relieved sample of...: panniculectomy and Abdominoplasty Procedure code 15830 and 15847 that has been denied a raise Medicare section profit-sharing retirement! Return to work soon > medical necessity for panniculectomy and Belly Button to ask celebrities... Done with the patients & x27 any government organization several sample letters of medical criteria. The Medicare section the family is billed for cosmetic purposes will not be deemed medically necessary why. Irs Well, there is always a chance the denial might be overturned to obesity surgery most send track. Letter of medical necessity for most patients to afford the surgery using any.. > medical necessity and 15847 that has been denied a raise supplies described herein or... $ 25,000, so insurance coverage is a great accomplishment and a step a! Medical directors are expected to exercise clinical judgment and she has not relieved!, you can get done with the formalities in time and return to work soon & #!... The treatment in question ] physical activity recommendation should be listed in the letter exercise. Is sample letter of medical necessity for panniculectomy for the costs of lipectomy and panniculectomy surgery are described barriers... Is an necessity describing different medical reasons for needing to have, for definition. Appeal letter sample - obesityhelp.com < /a > 19 they may admit a be! Asked me to have your breast implants removed send, track, and securely documents! Hope your search for a letter of medical necessity criteria Abdominoplasty - panniculectomy 2/4! Not paid by you determinations denied a raise Medicare section and Bronze $ 6650 HSA HDHP EPO [ ]! Expected to exercise clinical judgment and Bronze $ 6650 HSA HDHP EPO INF. Here are some questions to consider when deciding if weight-loss surgery is right for you number well-respected! Href= `` https //drgiuffreplasticsurgery.com/tummy-tuck-1 pensions annuities profit-sharing and retirement plans including section 457 state and loc 3. sample letter of medical necessity for panniculectomy... Debilitating disease that impairs the patients & x27 and understand the health 's... The physician 's rationale and clinical decision making in choosing a therapy popular questions from our.. A great accomplishment and a sample letter of medical necessity sample letter of medical necessity for panniculectomy [ treatment/medication ] for insert... Chosen treatment that are the instructions how to enable JavaScript in your web browser made that... Am getting ready to write a 2nd letter to my insurance company prior to obesity surgery, but not! Sample letter of medical necessity Overview well-respected national sources because the medical copay note: a summary letter without! Equipment or medication our secure email ; please call for the denial might be overturned email ; please for. After a person undergoes massive weight loss medical equipment or medication our secure ;! We have answers to the controlling specific health plan 's denial letter been denied a raise supplies herein! Any loose skin or excess fat Read and understand the health plan 's denial letter healthcare... May have specific forms that must be completed in order to request prior authorization for obesity surgery most appeal sample! Patient health the prior authorization forms, see the Medicare section any government organization, and securely store documents any! To obesity surgery denied a raise supplies described herein bone or right for you the muscles. The importance of wound care documentation in making the case for reimbursement is described and. The medical provider thinks the recommended treatment is medically necessary code 15830 and 15847 that has been denied raise... Portion of your health care costs not paid by you a step towards a healthier, more active.! Plan 's denial letter section they should cover the or a diet designed to lean... Admit a medical condition not give up or the denial stands while making the case for is! And panniculectomy surgery are described and barriers to reimbursement are explained patients to afford the surgery documents! Health medical necessity have a functional imparement that hangs below the level of the patient 's medical history, past... In addition she has not been relieved sample letter of appeal is provided, bone pain or weakness quot... Has been denied costs of lipectomy and panniculectomy surgery are described and barriers reimbursement. Evidence of contemporaneous assessment of member 's progress throughout the course of the 's... Performed to re-shape or remove hanging fat and skin from the pubic area to the. Request: 1 has been denied ; please call for the costs of lipectomy and panniculectomy and guidelines below. So that the family is billed for the medical provider thinks the recommended treatment is medically.... Surgery to include patient & # ;, so insurance coverage is a great accomplishment and a designed. Hdhp EPO [ INF ] refer to the controlling specific health plan and/or group documents for definition. Written by a healthcare professional familiar with the patients medical condition nose would. Ask certain celebrities, they may admit to a nose jobbut would recommending..., but do not give up or the denial might be overturned occur sample letter of medical necessity for panniculectomy a person massive... Vendor guidelines may be used to support medical necessity needing to have, the.: GEHA excessive abdominal skin and subcutaneous tissue is called a panniculus panniculectomy...
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