Question

In your opinion, is each of the following procedures likely to be considered medically necessary by a payer’s healthcare claims examiner? Why? A. Diagnosis: deviated septum Procedure: nasal surgery

Answer 1

complete question:

Hi! the question is incomplete here is the complete question

In your opinion, is each of the following procedures likely to be considered medically necessary by a payer’s health care claims examiner? Why?  

1.Diagnosis: deviated septum; Procedure: nasal surgery.

2.Diagnosis: mole on a female patient’s cheek, questionable nature; Procedure: surgical removal and biopsy.

3.Diagnosis: male syndrome hair loss; Procedure: implant hair plugs on the scalp.

4,Diagnosis: probable broken wristProcedure: comprehensive full-body examination, with complete set of lab tests, chest x-ray, and ECG.

5.Susie was seen in her dermatologist’s office because she wanted to remove a blemish on her arm not considered malignant and doing her no harm.  

Is the removal medically necessary and is it likely to be covered by health insurance?

Answers: before we get to answers first we need to understand the basic of health insurance that is "health insurance only deals with the health issues that are required to deal with for maintaining the health of a patient

1.answer is yes

explanation: because deviated septum is only corrected by surgery and there is no other way to deal with it, and it is a proper health issue requiring to be dealt with to maintain patient's health, this is why deviated septum will be covered by health insurance

2.The answer is yes

explanation: moles can be non-cancerous and cancerous which could be dangerous for the patient, so it is necessary to deal with the mole and treat it for the better health of the patient

3.The answer is no

explanation: this wouldn't be covered because hair loss in males is a cosmetic issue, not a life-threatening issue. only the life-threatening issues are covered

4.The answer is no

explanation: if a patient breaks hi's wrist only the wrist needs to be treated and examined not he whole body, the affected area is the body gets to be treated only, so the broken wrist would be examined by x-ray

and other necessary treatments for the broken wrist would be covered

5. The answer is no

explanation: Susie is in no dangerous health condition, the blemish she wants to be removed is not harmful or threatening to her life, and health insurance doesn't cover any issue that doesn't concern with the health of the patient, therefore the insurance will not cover the treatment of removing the blemish on her arm