2025 CPT code 15838
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Integumentary System Feed
Excision of excessive skin and subcutaneous tissue (including lipectomy) of the submental fat pad.
Modifiers may be applicable. Modifier 22 (Increased Procedural Services) is commonly used if the procedure is significantly more complex than usual.
Medical necessity must be established for insurance coverage. While often considered cosmetic, the procedure can be medically necessary if the excess tissue causes functional problems (e.g., difficulty swallowing, limited range of motion). Detailed documentation supporting the functional impairment is crucial.
The physician marks, incises, and removes excess skin and subcutaneous fat, sometimes using liposuction. They then close the incision.
In simple words: This procedure removes excess skin and fat under the chin (double chin) to improve appearance and function.
This code describes a surgical procedure to remove excess skin and subcutaneous tissue, including fat, from the submental area (under the chin or double chin). It often involves lipectomy (surgical removal of fat) and is performed to improve contour and function.
Example 1: A patient with a large submental fat pad causing cosmetic concerns undergoes lipectomy and skin excision using code 15838., A patient with excess skin and fat under the chin causing difficulty swallowing or neck movement undergoes the procedure described by 15838., A patient post significant weight loss has redundant skin and fat in the submental area. The physician performs the excision described by code 15838.
Documentation should include the size and location of the excess tissue, any functional impairments, pre- and postoperative photographs, operative details (including techniques used), and pathology reports if applicable.
** Reimbursement for this code can vary significantly among payers, as it is often viewed as a cosmetic procedure. Strong documentation supporting medical necessity is essential. Pre-authorization from the insurance company may be required. Always verify coverage with the payer before performing the procedure.
- Payment Status: Potentially Varies by Payer
- Specialties:Plastic Surgery, Otolaryngology, General Surgery, Maxillofacial Surgery
- Place of Service:Ambulatory Surgical Center, Hospital Outpatient Department, Physician's Office