Plastic & Reconstructive Surgery Billing Solutions
Maximize your plastic surgery practice revenue with specialized billing expertise in cosmetic versus reconstructive coding, medical necessity documentation, and complex modifier management. Our certified coders understand the unique requirements of both insurance-covered reconstructive procedures and patient-pay cosmetic services.
Proven Results
32% Average Revenue Increase
96% First-Pass Claim Rate
45% Reduction in Denials
12 Days Faster Payment Collection
Common Billing Challenges
Cosmetic vs Reconstructive Coding
Distinguishing between cosmetic procedures (patient-pay) and reconstructive procedures (insurance-covered) requires precise documentation and coding expertise.
Medical Necessity Documentation
Proving medical necessity for reconstructive procedures requires extensive documentation, clinical photos, and detailed operative reports.
Modifier Complexity
Plastic surgery procedures require complex modifier usage for staged procedures, bilateral surgeries, and multiple procedures performed simultaneously.
Insurance Coverage Determination
Determining which procedures are covered by insurance versus patient-pay requires knowledge of payer policies and coverage criteria.
Prior Authorization Challenges
Reconstructive procedures often require extensive prior authorization with clinical documentation, photos, and supporting medical records.
Multiple Procedure Bundling
Understanding which plastic surgery procedures can be billed together and which are subject to NCCI edits and bundling rules.
Our Solutions
Certified Plastic Surgery Coders
Our team includes certified coders with specialized training in plastic and reconstructive surgery coding and documentation requirements.
Expertise in cosmetic vs reconstructive distinction
Knowledge of complex modifier requirements
Understanding of payer-specific policies
Reduced coding errors and denials
Insurance Verification Systems
Advanced systems verify coverage for reconstructive procedures and identify patient-pay cosmetic services before treatment.
Accurate coverage determination
Clear patient financial expectations
Reduced billing disputes
Improved patient satisfaction
Medical Necessity Documentation
Comprehensive support for documenting medical necessity with clinical photos, operative reports, and supporting evidence.
Higher approval rates for reconstructive procedures
Reduced claim denials
Faster prior authorization processing
Complete documentation compliance
Revenue Optimization
Strategic billing approaches to maximize reimbursements for covered procedures while managing patient-pay cosmetic services.
Increased revenue per procedure
Optimized modifier usage
Faster payment collection
Improved cash flow management
Specialized Services
Reconstructive Procedures
Expert billing for medically necessary reconstructive surgery including trauma reconstruction, burn reconstruction, and congenital defect repair.
Trauma reconstruction
Burn surgery billing
Congenital repair
Scar revision procedures
Cosmetic Procedures
Patient-pay billing management for elective cosmetic procedures with clear payment processing and collection systems.
Aesthetic surgery billing
Facial procedures
Body contouring
Injectables and fillers
Post-Mastectomy Reconstruction
Specialized billing for breast reconstruction following mastectomy with knowledge of Women\
Breast reconstruction
Implant procedures
Flap surgery billing
Revision procedures
Hand & Microsurgery
Complex billing for hand surgery and microsurgical procedures including nerve repair, tendon repair, and tissue transfer.
Hand surgery procedures
Microsurgical billing
Nerve repair coding
Tissue transfer procedures
Client Testimonial
Medtransic's expertise in both cosmetic and reconstructive billing has been invaluable.
Their team understands the nuances of medical necessity documentation and modifier usage,
which has increased our reconstructive procedure revenue by 35% while streamlining our
cosmetic patient-pay collections.