Diastasis recti surgery is sometimes covered by some insurance companies but is often not covered. Diastasis Recti repair, despite the similarity to (and often coinciding with) a hernia, is essentially the same procedure as a tummy tuck. For this reason, it is often NOT covered by insurance.
Full Answer
Is diastasis recti covered by insurance?
Diastasis Despite its resemblance to (and often coexistence with) a hernia, recti correction is essentially the same treatment as a belly tuck. As a result, it is frequently covered by insurance.
What is diastasis recti surgery?
Diastasis Recti Surgery A diastasis recti is a separation of the abdominal muscles. This happens when the rectus abdominis muscle separates more than 2.7 cm. It is most common in pregnant females and newborn babies, but can also happen to men.
How much does a diastasis recti hernia tuck cost?
Tummy tucks can average around $5,500 for just the surgery. There are additional fees for the hospital, anesthesiologist, and medications. This can put the cost well over that. On average, the total cost can amount to well over $10,000. On rare occasion, a diastasis recti can herniate in adults.
What is the risk of diastasis recti in the third trimester?
The likelihood of developing diastasis recti in the third trimester is as high as 66%. What it looks like is an unwanted belly “pooch” that can last even after you’ve lost the pregnancy weight. And in rare, severe cases, diastasis can evolve into a painful abdominal hernia.
Does Medicare cover diastasis recti?
Diastasis recti repair is not covered by insurance and cannot be submitted to Medicare.
Will insurance cover a tummy tuck for diastasis recti?
Surgery is an option, but is usually not covered by insurance since it is considered to be cosmetic; the surgical procedure most commonly used to treat DR is also known as a “tummy tuck,” used to make the abdomen thinner and firmer.
How much does it cost to repair diastasis recti?
A diastasis recti repair can cost anywhere from $5,000 to $19,000. The actual cost of a diastasis recti repair is dependent upon location, board certified plastic surgeon, and length and involvement of the plastic surgery.
Is diastasis recti repair medically necessary?
Repair of diastasis recti is considered cosmetic and not medically necessary.
Is diastasis recti ever covered by insurance?
Just like abdominoplasty, a diastasis recti repair is generally not covered by insurance because it's considered cosmetic and not medically necessary. Insurance companies may pay for it if a diastasis recti surgical repair needs to be done to correct a hernia.
Can diastasis recti be fixed after 20 years?
It's never too late to repair your diastasis recti. With the proper exercises, you can fix your ab separation years after you've delivered your last baby.
What is considered a large diastasis recti?
If you feel a gap of at least two finger widths between the muscles as they contract, you have a diastasis. A gap as wide as four or five fingers is considered severe. Repeat the procedure below and above your belly button because the separation may be wider in different places.
How painful is diastasis recti surgery?
Since diastasis recti surgery involves muscle repair, you should expect some muscle soreness and pain for the first few days after your surgery. Your wounds will also show some swelling and bruising. These symptoms might take up to 2 weeks to subside.
What kind of doctor fixes diastasis recti?
During the procedure, the midline connective tissue is shortened and reinforced and the abdominal muscles are positioned appropriately. Diastasis recti repair is usually performed by a general surgeon to strengthen a hernia repair and decrease hernia recurrence.
How can I get insurance to cover diastasis recti?
For insurance to cover a surgical problem it must be a functional one. In your case, you may have diastasis recti, but your symptoms are due to intra-abdominal weight gain, which will not be changed by tightening you rectus muscles.
What happens if diastasis recti goes untreated?
If left untreated, diastasis recti can potentially lead to poor core stabilization, pelvic floor dysfunction, and back or pelvic pain.
Can a tummy tuck be medically necessary?
Liposuction is considered cosmetic and not medically necessary when used for the removal of excess abdominal fat. Abdominoplasty when done to remove excess skin or fat with or without tightening of the underlying muscles is considered cosmetic and not medically necessary.
What is the term for when the rectus abdominis muscles can become spread apart from weight gain or pregnancy
I am sorry to hear about the difficulties you are having. Diastasis recti is when the rectus abdominis muscles can become spread apart from weight gain or pregnancy. Intraabdominal contents then bulge through the space between the rectus muscles.
Is rectus muscle repair covered by insurance?
Rechandle: I am very sorry to hear about your stomach symptoms. Unfortunately, repair of your rectus muscles is not typically covered by insurance companies (at least, I have never had success in getting it covered and neither have my peers).
Does insurance cover hernia surgery?
Insurance does not cover this as it is not a hernia. It is usually combined with a tummy tuck. It's worth it! Get a consult with an ASPS board certified plastic surgeon. The diastasis is a weakness in the abdominal muscle ( stretching) that can be corrected with surgical repair to reposition the muscles.
Does insurance cover diastasis recti?
For insurance to cover a surgical problem it must be a functional one. In your case, you may have diastasis recti, but your symptoms are due to intra-abdominal weight gain, which will not be changed by tightening you rectus muscles. If you were able to loose the weight that you have gained, then your muscles could be repaired to improve your abdominal contour, which would be considered cosmetic in nature.
What is diastasis recti?
A diastasis recti is a separation of the abdominal muscles. This happens when the rectus abdominis muscle separates more than 2.7 cm. It is most common in pregnant females and newborn babies, but can also happen to men. The doctor can find it by having the patient lie flat on his or her back and bend the knees upward while keeping the feet flat.
How much does a tummy tuck cost?
Tummy tucks can average around $5,500 for just the surgery. There are additional fees for the hospital, anesthesiologist, and medications. This can put the cost well over that. On average, the total cost can amount to well over $10,000. On rare occasion, a diastasis recti can herniate in adults. This is most common in pregnant women ...
How to bring abdominal muscles back together?
Doctors may have the patient attempt exercise first to bring the abdominal muscles back together. This includes heel slides, leg stretches, and pelvic tilts. Exercise should aim to keep the core muscles tight and not allowing them to push outward.
Is diastasis recti life threatening?
If a hernia is questioned, an ultrasound can be ordered. Diastasis recti is not an actual hernia and is not life-threatening but diastasis recti surgery is needed sometimes.
Can you do diastasis surgery without a major incision?
The surgical interventions depend on the needs of the patient and how much diastasis is involved. The doctor may be able to do the surgery laparoscopically without a major incision, but more involved surgeries may require an open abdominal surgery.
Can a diastasis recti herniate?
On rare occasion, a diastasis recti can herniate in adults. This is most common in pregnant women that had con genital diastasis recti at birth that did not fully develop and close. If herniation does occur after pregnancy, surgery may be required and in this case the insurance will cover surgical repair of the condition.
How to treat diastasis recti?
Strengthen Your Core Muscles. One of the most effective treatments for diastasis recti is exercise to rebuild strength and the integrity of your abdominal muscles . A strong core reduces back pain and diminishes the stubborn mummy tummy.
What is the likelihood of developing diastasis recti in the third trimester?
The likelihood of developing diastasis recti in the third trimester is as high as 66%. What it looks like is an unwanted belly “pooch” that can last even after you’ve lost the pregnancy weight. And in rare, severe cases, diastasis can evolve into a painful abdominal hernia.
What are the factors that contribute to diastasis recti?
There are a few factors that can contribute to the severity of diastasis recti, and understanding some of these factors may help you better prepare for your post-pregnancy recovery and what you can expect. Carrying a large baby. Carrying multiples (twins or triplets) Having a weak abdominal wall. Genetics.
How to reduce diastasis recti pain?
In essence, it's being mindful of your body's positioning and making sure you're carrying your body in the best alignment to reduce the symptoms of diastasis recti like lower back and pelvic pain.
Where does diastasis recti occur?
Diastasis recti happens at the linea alba midline around the belly button, above or below the navel , and in some severe instances, postpartum women may experience completely open diastasis recti. Trauma in abdominal region is an important cause behind Diastasis Recti.
Is diastasis recti painful after pregnancy?
Just because it's not dangerous, doesn't mean it's not uncomfortable . Here are common symptoms that can result from post-pregnancy diastasis recti.
Is postpartum diastasis recti dangerous?
Thankfully, most cases of postpartum diastasis recti aren't dangerous. However, because your abdominal muscles play a significant role in trunk control and function, a compromised abdomen can reduce your strength, range of motion, affect breathing, and weaken your pelvic floor.