Medicare Part C Medical Coverage Policy Breast Reduction - Blue Cross NC This calculator yields the required weight of tissue to remove with just knowledge of the patient's height and weight and the use of a straight edge. trailer Careers. 0000000016 00000 n I am currently a 38DD with severe upper back and shoulder pain. Should I be worried if I have silverfish? 1991 Sep;27(3):232-7 . I couldn't find information on the 5th percentile anywhere. 5. Policy Number : MP.004.24 Effective Date: April 1, 2023 Instructions for Use For example, the familiar Schnur sliding scale was devised as a nomogram that relates resected breast weight to body surface area and defines surgeries resulting in resection weights above the 22nd percentile as being reconstructive, whereas those below the fifth percentile as cosmetic. How do you use Square reader for the first time? While this practice continues, our simplified Schnur Sliding Scale nomogram is meant to help easily determine the insurer-required minimum breast resection weight and thereby both improve patient counseling prior to planning surgery and assist the surgeon with achieving insurer reimbursement for the procedure while avoiding rejected claims. If the individual's body surface area and weight of breast tissue removed fall below the 22nd percentile, then the surgery is not medically necessary. 0 1999;42:107-8. 2021 Mar 1;147(3):382e-390e. Average weight of tissue planned to be removed in each breast, is above the 22nd percentile on the Schnur Sliding Scale based on the patient's body surface area (BSA) This Schnur chart may be used to assess whether the amount of tissue (per breast) that will be removed is reasonable for the body habitus, and whether the procedure is cosmetic The most reliable method for evaluating your eligibility for breast reduction is the Schnur Sliding Scale, which allows Dr. Omidi to determine the right tissue amount to be removed from each breast. If the amount plots A Schnur sliding scale percentile was also . d Average weight of tissue planned to be removed in each breast, is above the 22nd percentile* on the Modified Schnur Sliding Scale based on the patient's body surface area (BSA)**. Save my name, email, and website in this browser for the next time I comment. 0000004621 00000 n <>stream I understand what my BSA is and what the corresponding amount of tissue that would need to be removed according to the scale. I can't post the entire article due to copyright, but I can share what I got from it. Wampler AT, Powelson IA, Homa K, Freed GL. This Schnur chart may be used to assess whether the amount of tissue that will be removed is reasonable for the body habitus, and whether the procedure is cosmetic or reconstructive in nature. This Schnur chart may be used to assess whether the amount of tissue (per breast) that will be removed is reasonable for the body habitus, and whether the procedure is cosmetic or reconstructive in nature. I know some people have been denied due to solely the Schnur scale despite other factors like pain/rashes/etc and I want to know if that could happen to me. Taken from the Schnur Sliding Scale . Schnur pointed out that if a payer used weight of resected tissue as a coverage criterion, then if the weight fell below the 5th percentile, the reduction mammaplasty would be considered cosmetic; if above the 22nd percentile, it would be considered medically necessary; and if between these cutpoints, it would be considered on a case-by-case basis. The weight of tissue to be removed from each breast must be above the 22nd percentile on the Schnur Sliding Scale (Appendix A below) based on the individual's body surface area (BSA). Here's the data that includes 5th percentile values (image below) https://docs.google.com/spreadsheets/d/1MOQpsG0do5Gy0x3ihKbYPWvhoyEL87EzF4qpelN1JVU/edit?usp=sharing. We would like to show you a description here but the site won't allow us. Lower 5% Lower 22% 1.35 127 199 1.40 139 218 1.45 152 238 1.50 166 260 1.55 181 284 1.60 198 310 . x n. Calculate the rank r for the percentile p you want to find: r = (p/100) * (n - 1) + 1. Please enable it to take advantage of the complete set of features! And voila! How do I backup my iPhone when I get a new one? 0000041762 00000 n breast reduction, insurance, nomogram, reduction mammaplasty, reimbursement, sliding-scale, Schnur, surface area.

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