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Tit Talks #1 - CMS Codes & DIEP Flap Breast Reconstruction
Manage episode 377021542 series 3439740
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In this episode of "Tit Talk," Rosalina explores the challenge posed by the federal government agency CMS, and the significant development in 2019 that affected one of the most popular breast reconstruction surgery options, the DIEP Flap Reconstruction.
She examines how this surgery was no longer 100% covered by insurance due to changes in policy, creating challenges for patients and surgeons alike and potentially resulting in financial difficulties, particularly for underserved communities who would be burdened with out-of-pocket costs. Rosalina addresses the financial hardships faced by individuals diagnosed with breast cancer and emphasizes the critical need for equitable access to appropriate treatment options.
The episode wraps up by highlighting the efforts of the Community Breast Reconstruction Alliance (CBR), Dr. Elizabeth Potter, various patient-driven advocacy organizations, and individuals who tirelessly advocated for the reversal of the billing code changes. Their successful initiatives led to CMS reversing its decision by August 2023.
Rosalina encourages listeners to reflect on the broader implications of this issue and stresses the importance of ensuring fair access to breast reconstruction choices for all cancer patients.
Resources:
- https://cbralliance.org/https://www.lbbc.org/news/women-who-rebuild-both-breasts-with-diep-flap-surgery-see-more-issues
- https://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/whcra_factsheet
- https://www.lbbc.org/news/stop-new-limits-on-breast-reconstruction
- https://www.healthcentral.com/condition/breast-cancer/cost-of-breast-cancer-treatment
- https://www.breastcancer.org/news/diep-flap-surgery-cms-code-change
- https://canceradvocacy.org/wp-content/uploads/Group-letter-to-CMS-re-DIEP-flap-surgery-code-4-3-23.pdf
- TRAM Flap: https://www.breastcancer.org/treatment/surgery/breast-reconstruction/types/autologous-flap/tram
- CPT Billing Codes For DIEP Flap:S2066, S2067, and S2068
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