{"id":2550,"date":"2017-08-06T18:19:58","date_gmt":"2017-08-06T18:19:58","guid":{"rendered":"https:\/\/www.newyorkurologyspecialists.com\/peyronies\/?page_id=2550\/"},"modified":"2020-06-09T05:25:46","modified_gmt":"2020-06-09T05:25:46","slug":"insurance","status":"publish","type":"page","link":"https:\/\/www.newyorkurologyspecialists.com\/peyronies\/penile-plication\/insurance\/","title":{"rendered":"Insurance Coverage – Penile Plication for Treatment of Penile Curvature in Peyronie’s Disease"},"content":{"rendered":"

Insurance Coverage for Penile Plication Surgery for the Treatment of Peyronie’s Disease<\/h1>\n

by Alex Shteynshlyuger MD<\/a><\/strong><\/p>\n

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If you have any questions, to schedule a consultation<\/a>, please contact us<\/a> or call\/text: <\/strong>1-646-663-4050<\/span><\/a>.<\/strong><\/p>\n

We have excellent reviews from patients <\/a><\/strong>and their partners.  Information for out-of-state and international patients<\/a>.  <\/strong><\/span><\/p>\n

We offer affordable prices<\/a> with or without insurance.<\/strong><\/span><\/p>\n

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Is Penile Plication Covered by Insurances?<\/strong><\/h2>\n

\"\"Penile plication<\/strong><\/a> procedures such as 16-dot-plication and Nesbit plication are typically covered by healthcare insurance plans<\/strong> such as Cigna, AETNA, UnitedHealthcare, Oxford, Blue Cross Blue Shield plans if it is performed to correct a functional problem that interferes with bodily functions<\/strong>.<\/p>\n

In the case of Peyronie’s disease and congenital penile curvature, penile plication is typically covered if <\/strong>a patient has pain with erections<\/a><\/strong>, difficulty with having intercourse due to the curvature<\/a><\/strong> or inability to have intercourse.  It is also covered if penile curvature causes distress and affects self-esteem<\/strong> and difficulty with relationships.<\/p>\n

Penile plication is typically not covered by insurance companies if it is performed for the sole reason of improving the cosmetic appearance of the penis in a patient who does not have a functional problem.<\/p>\n

It is always a good idea to verify insurance coverage before the procedure<\/strong> and if necessary appeal denial of coverage decision prior to having penile plication surgery<\/strong>.<\/p>\n

Warning:<\/strong>  Insurances love to deny penile plication inappropriately.  Often, an appeal of their initial decision is necessary for them to approve the procedure.<\/p>\n

At New York Urology Specialists, we work with your insurance to pre-authorize surgery<\/strong> to ensure that your insurance pays for the procedure.  We appeal insurance denials on your behalf as well.<\/strong><\/p>\n

What is Necessary for Insurance to Approve Penile Plication?<\/strong><\/h2>\n

Insurance may require that patients try another therapy<\/strong> such11 as injection therapy with Xiaflex<\/a><\/strong> or verapamil<\/a><\/strong> prior to approving penile plication. <\/p>\n

The evaluation usually involves the induction of penile erection with measurement of penile curvature<\/a><\/strong> as well as a penile Doppler ultrasound<\/a><\/strong> to evaluate the penile anatomy and vascular function.  Evaluation of erection quality is also part of this process.  Insurances typically want to see that a patient undergoes a full evaluation to determine if alternative therapy is appropriate. <\/p>\n

One of the required criteria for surgical treatment of Peyronie’s disease is that the disease process is fairly stable – there should be no new changes in curvature in the past 6 months<\/strong>. <\/p>\n

Did you know?<\/strong>  <\/span>Dr. Shteynshlyuger has performed over 1,000 penile surgeries<\/strong> including penile implants, correction of Peyronie’s disease, circumcisions, circumcision revisions, frenuloplasty, and congenital penile curvature.  He performs 150-200 penile surgeries a year.<\/p>\n