As a plastic, primarily cosmetic surgeon, I often undertake cosmetic surgery in conjunction with non-cosmetic surgery on the same patient at the same time. A common example: bilateral breast reduction, which health insurers usually regard as medically necessary and therefore cover, and abdominoplasty, which health insurers rarely cover. Doing so can prove a little problematic. You're not only dealing with two payors — the patient's health insurer and the patient herself — but also, to some extent, a doubling of paperwork related to the documentation of surgery and surgical specimens. Here's advice for getting reimbursed for combined surgery. As you'll see, the key is to segregate the documentation of the procedures to avoid confusing the health insurer.