The federal government is reconsidering a decision that breast cancer patients, plastic surgeons, and members of Congress have protested would limit women's options for reconstructive surgery.
The federal government is reconsidering a decision that breast cancer patients, plastic surgeons, and members of Congress have protested would limit women's options for reconstructive surgery.for a type of breast reconstruction known as DIEP flap, in which skin, fat, and blood vessels are harvested from a woman's abdomen to create a new breast.
Codes don't dictate the amounts private insurers pay for medical services; those reimbursements are generally worked out between insurance companies and medical providers. However, using the narrowly targeted S code, doctors and hospitals have been able to distinguish DIEP flap surgeries, which require complex microsurgical skills, from other forms of breast reconstruction that take less time to perform and generally yield lower insurance reimbursements.
Cost is not necessarily the only hurdle patients seeking DIEP flaps must overcome. Citing the complexity of the procedure, Getz said, a local plastic surgeon told her it would be difficult for him to perform. She ended up traveling from Illinois to Texas for the surgery. In a May 30 statement, Blue Cross Blue Shield Association spokesperson Kelly Parsons reiterated the organization's view that"there is no longer a need to keep the S codes."
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