It results in a significant reduction in the size of the breast change in shape and an uplifting effect on the breast tissue. Is A Breast Reduction Covered By Insurance.
Breast Reduction My Insurance Will Pay For That Dr Michaels Blog
Breast reduction is a covered service in the non-diseased breast to achieve symmetry following contralateral mastectomy partial mastectomy or lumpectomy based on the WHCRA regulations.
Does blue cross blue shield cover breast reduction. Also Available With Finance. Does Blue Cross Blue Shield Cover Breast Reduction. The criteria are the symptoms like back and neck pain rashes under the breasts and large breasts.
2 Body Surface Area m2 and Weight of Breast Tissue Removed per breast Body Surface Area m2 Minimum Grams of Breast Tissue to be Removed 135 199 140 218 145 238 150 260 155 284 160 310 165 338 170 370 175 404 180 441. Is A Breast Reduction Covered By Insurance Previous. Breast reduction may also be covered in females for whom growth is complete 18 years of age or older who have enlarged breasts macromastia when the following criteria have been met.
Supported by Blue Cross NC through administrative or operational services. A Division of Health Care Service Corporation a Mutual Legal Reserve Company an Independent Licensee of the Blue Cross and Blue Shield Association page 2 of 6 Revised 122008 Breast Reduction Reduction Mammaplasty for Systematic Breast. Without prosthetic implant Note.
If you have the right symptoms but the breasts arent large enough they may not approve the surgery. Each insurance company such as Blue Cross Blue Shield has its own standards on what qualifies a patient for insurance coverage of a breast reduction. Supply is medically necessary does not constitute a representation or warranty that the Blue Cross and Blue Shield Service Benefit Plan covers or pays for this service or supply for a particular member.
FEP 70121 Reduction Mammaplasty for Breast-Related Symptoms. Ad Discover Our Incredible Prices on Breast Reductions. Reduction mammoplasty is a surgical procedure designed to remove a variable proportion of breast tissue.
DESCRIPTION OF PROCEDURE OR SERVICE Reduction mammoplasty is the surgical reshaping of the breasts to reduce or lift enlarged or sagging breasts. Blue Cross Blue Shield generally will cover a breast reduction if you meet their criteria. BlueCross BlueShield of Tennessee Medical Policy Manual.
Breast reduction for psychological reasons is also excluded. The presence of symptoms related to your large breast size such as neckbackshoulder pain are important in showing medical necessity which it sounds like you have from your description. Does BCBSIL Cover Breast Reduction Surgery.
BCBSNC will cover Reconstructive Breast Surgery after Mastectomy Surgical Treatment of Gynecomastia Reduction Mammaplasty for Breast Related Symptoms Risk-Reducing Mastectomy and Surgical Management of Breast Implants when it is medically necessary because the criteria shown below have been met. Connect With Our Surgeons Online For Free To Find Out More About Our Breast Reductions. To state that these procedures are considered cosmetic and not medically necessary except when performed as part of a covered breast reconstruction service.
Reduction Mammaplasty Non-Cancerous Reduction Mammoplasty. Reduction Mammaplasty for Systematic Breast Hypertrophy or Hypermastia Answer. Breast reduction performed strictly for cosmetic reasons is not covered see also Cosmetic Reconstructive Surgery.
Blue Cross Blue Shield breast reduction will cover your breast reduction in many cases but only if you fulfill their criteria. Also Available With Finance. Generally the acceptance of coverage depends on a combination of symptoms and removal of a certain amount of weight.
Breast Reduction Coverage Requirements. Connect With Our Surgeons Online For Free To Find Out More About Our Breast Reductions. Yes if you meet their list of requirements and receive a pre-authorization.
Code deleted 12312020. November 11 2018. Reduction Mammaplasty for Breast-Related Symptoms.
For PREDETERMINATION REQUESTS there should not be any commitment of coverage unless documentation has been received and. Insurance coverage for breast reduction. Ad Discover Our Incredible Prices on Breast Reductions.
Wed recommend talking over these requirements with your doctor as they will be more familiar with the pre-auth process. REDUCTION MAMMAPLASTY SUR716012 _____ COVERAGE. Usually that includes back and neck pain rashes under the breasts and large breasts which are large enough.
Breast Reduction Coverage Requirements Previous. The criteria for insurance coverage of breast reductions varies depending on the insurance company and on the specific insurance plans within that company. Instead please fax the request to Anthem Blue Cross Grievance and.
Coverage WILL NOT BE ALLOWED for Reduction Mammaplasty procedures done for cosmetic reasons unless documentation for medical necessity has been obtained. Does Blue Cross Blue Shield Cover Breast Reduction. You must know that if you have not had large enough breasts they will not approve the surgical operation.