Wiki Help with Breast Removal

[TERESA TAYLOR]

Hello all,
Need some advice -- Patient had R Breast removed a year ago for breast cancer. She is very uncomfortable ( feels off balance, shoulder and back pain) on the left side now and wonders if Medicare will pay for her to have it removed. Thanks in advance for your help.

 

[ajs]

Hello all,
Need some advice -- Patient had R Breast removed a year ago for breast cancer. She is very uncomfortable ( feels off balance, shoulder and back pain) on the left side now and wonders if Medicare will pay for her to have it removed. Thanks in advance for your help.

I would contact your Medicare carrier and find out the answer to that question. It may come down to the medical necessity of removing the other breast.

 

[FTessaBartels]

Or ....

Is reconstruction of the removed breast NOT covered by Medicare? I was under the impression that this is a covered procedure when the removal was for cancer diagnosis.

Not sure of this, as it is out of my area of expertise, but I know at least one woman covered by Medicare that had reconstructive surgery.

Hope that helps.

F Tessa Bartels, CPC, CEMC

 

[ajs]

Is reconstruction of the removed breast NOT covered by Medicare? I was under the impression that this is a covered procedure when the removal was for cancer diagnosis.

Not sure of this, as it is out of my area of expertise, but I know at least one woman covered by Medicare that had reconstructive surgery.

Hope that helps.

F Tessa Bartels, CPC, CEMC

I believe reconstruction of a removed breast is covered, but this question was about a patient having the other non-cancerous breast removed because she is uncomfortable. It may be that she did not want to have reconstruction done when the other side was removed, or it may not have been possible. Certainly we need more information regarding the issue, but probably best served by contacting her Medicare carrier for advice!