One of the most frequently confusing issues for patients is the cost of rhinoplasty. Rhinoplasty, external nose reshaping, which is frequently a cosmetic procedure (although not always) is often confused with Functional Nasal Airway Surgery whose onjective is to improve breathing and is often covered by medical insurance.

Th confusion comes in as many patients believe that if they have a breathing problem with their nose that they then can get their reshaping rhinoplasty done under insurance reimbursement. This belief is both inaccurate and fraudulent.  Medical insurance may pay for functional nasal airway surgery such as septoplasty, turbinate reduction and repair of nasal vestibular stenosis with cartilage grafts. All of these procedures aim to provide a functional improvement by making one breathe through their nose better. None of these procedures will make any significant difference in the outward appearance of your nose As soon as any procedure is done to change the appearance of your nose, such as hump reduction or tip lifting or narrowing, this enters the realm of a cosmetic rhinoplasty which has no impact on breathing improvement. The only time that any external changes to the nose is covered by medical insurance is if the abnormal appearance of the nose is due to a birth defect (such as cleft lip or palate or other craniofacial deformity) or an accident. (if it is due to an accident, this event must be documented with medical records that substantiate the injury…just saying it happened won’t cut it)

One of the frequent motivations for nasal breathing surgery is to have the nose reshaped at the same time. This is perfectly understandable, achieve two goals at the same time and is commonly done. The rub comes in from a money standpoint. Some patients believe, however, that ‘once you are there doing one thing, you can just the other thing…how does insurance know what you are doing?’ Trust me, they do. The hospital/surgery center knows and I know. It is fraudulent to have your medical insurance carrier ‘pay’ for the cosmetic portion of your nose surgery. In today’s world, the hospital or surgery center knows what is going on in any nose procedure and will ask for payment up front. Any responsible plastic surgeon will as well.

Dr Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis