erikarose727
New
Can you bill insurance the DME code for a surgical bra post breast reduction surgery? The bra is provided at the first post op appointment, and is NOT placed the same day of surgery.
That's what I figured. Thank you so much for the feedback! Would your carrier cover a mastectomy bra after a tissue expander has been placed?I work for an insurance carrier, and the only bras we cover are mastectomy bras, which have an annual limit on the number of bras covered per year. We would not cover a surgical bra for a member after breast reduction surgery.
On our commercial lines of business, we allow a combination of 2 units per benefit period of L8000-L8002 & S8460(camisole, postmastectomy) and our Medicare Advantage line of business we Medicare LCD L33317 External Breast Prosthesis and article A52478 External Breast Prosthesis for L8000-L8002, which do not include coverage for S8460.That's what I figured. Thank you so much for the feedback! Would your carrier cover a mastectomy bra after a tissue expander has been placed?
This was very helpful, thank you.On our commercial lines of business, we allow a combination of 2 units per benefit period of L8000-L8002 & S8460(camisole, postmastectomy) and our Medicare Advantage line of business we Medicare LCD L33317 External Breast Prosthesis and article A52478 External Breast Prosthesis for L8000-L8002, which do not include coverage for S8460.
You best for determining coverage guidelines and limitations on mastectomy bras is to check each of the carriers you work with