What is the diagnosis code for breast reduction?

Group 1

Code Description
19316 MASTOPEXY
19318 BREAST REDUCTION

How do you prove medical necessity for breast reduction?

What makes a breast reduction medically necessary?

  1. You have severe rashes or skin infections that are hard to treat.
  2. Your physical activities are restricted.
  3. You have nerve compression due to the weight of the breasts.
  4. The weight of your breasts is significantly affecting your posture and spine alignment.

What makes you qualified for a breast reduction?

You may qualify for insurance coverage for your breast reduction if you have significant symptoms caused by your heavy breasts, such as: A history of rashes that required medication. Numbness or tingling in your arms. Shortness of breath when lying down.

What is the code for reduction mammoplasty?

Reduction Mammoplasty (CPT 19318) This procedure will be denied when performed for a cosmetic reason.

What is the ICD-10 code for history of breast reduction?

89.

What is ICD-10 code for large breasts?

ICD-10 code N62 for Hypertrophy of breast is a medical classification as listed by WHO under the range – Diseases of the genitourinary system .

How much does DDD cup breast weigh?

DDD cups usually weigh around 5-6 pounds, which is roughly 2.5-3 pounds for each breast. This is about 20-30% heavier than DD breasts and 50% heavier than D breasts.

What is medically necessary breast surgery?

What does ‘Breast surgery (medically necessary) mean? Hospital treatment for the investigation and treatment of breast disorders and associated lymph nodes, and reconstruction and/or reduction following breast surgery or a preventative mastectomy.

When is breast reduction medically necessary?

There are several health concerns that can help qualify you for Breast Reduction Surgery and make it medically necessary including: Chronic skin infections due to larger breasts. The common one is intertrigo. Relief from body pain; back pain, neck pain or shoulder pain.

How small can you go for a breast reduction?

Summary: The answer to the question “How many cup sizes can I go down with a breast reduction?” is: as small as the patient would like, provided there is enough breast tissue to support the functions of the nipples.

What is the ICD-10 code for status post breast reduction?

What is the ICD-10 code for bilateral breast reduction?

Added new ICD-10 codes: M40. 14, M40.