Does Medicare cover a laparoscopy?
This article was updated on: 10/06/2018
Laparoscopy is also called minimally invasive surgery, according to the American College of Obstetricians and Gynecologists. Laparoscopic surgery can result in faster recovery times. Read about some of the benefits and risks of laparoscopy, and whether Medicare covers it.
What is laparoscopy?
Let’s start with the definition of laparoscopy. Laparoscopy is a type of screening where the doctor feeds a tiny camera through a small incision and examines the resulting images, according to a Harvard Medical School publication. A doctor may use laparoscopy to diagnose conditions or to perform certain types of operations.
According to the American Society of Colon and Rectal Surgeons (ASCRS), doctors can sometimes perform laparoscopic surgery on abdominal and pelvic organs while viewing a video monitor. The surgeon may make other small incisions to insert instruments to perform procedures, or to take a small sample of tissue (biopsy) from an organ to examine.
What are the benefits and risks of laparoscopy?
Laparoscopy generally requires a smaller cut to the body than open surgery. In general, minimally invasive surgery is associated with less pain, a shorter hospital stay, and fewer complications, according to the Mayo Clinic. However, the American College of Obstetricians and Gynecologists notes that risks might include bleeding or damage to blood vessels or tissues. Also, laparoscopy can take longer than open surgery, which may mean you’re under anesthesia for longer. Anesthesia can increase the risk of complications. There may be other benefits and risks; you may want to discuss them with your doctor.
When might Medicare cover laparoscopy?
Medicare Part A or Part B might cover laparoscopy in some situations. For example, Medicare might cover a type of weight-loss procedure called bariatric surgery by laparoscopy in some cases. Your laparoscopy generally must meet at least two basic requirements for Medicare coverage:
- The hospital and physicians performing the laparoscopy must accept Medicare assignment.
- Laparoscopy must be medically necessary.
Other criteria may apply before Medicare covers certain types of laparoscopy. For example, you must meet additional criteria in order for Medicare to cover laparoscopy and weight loss surgery. Learn more about surgical weight loss treatment and Medicare coverage.
Depending on the situation, your surgeon might schedule laparoscopy as inpatient or outpatient surgery. If your laparoscopy meets the requirements, Medicare Part A generally covers hospital services related to inpatient surgery after you have paid your Part A deductible. Medicare Part B may cover 80% of the Medicare-approved amount for outpatient laparoscopy after you have paid your Part B deductible.
If you’re enrolled in a Medicare Advantage plan, deductibles, coinsurance, and copayments for laparoscopy may be different from Medicare Part A and Part B cost shares. You can contact your Medicare Advantage plan’s customer service for specific coverage information.
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