New CMS Coding Shortchanges Natural-Tissue Breast Reconstruction [Video]

Until recently, deep inferior epigastric perforator (DIEP) flap breast reconstruction and other perforator flap breast reconstruction surgeries had unique procedure codes. In 2019, CMS decided to combine all flap breast reconstruction procedures together under one code and to phase out unique codes for individual flap procedures by December 31, 2024, according to Breastcancer.org.

Elisabeth Potter, MD, is a plastic surgeon in Austin, Texas, who specializes in DIEP flap breast reconstruction. In this video, she discusses how the CMS code change for breast reconstruction surgeries will shift physician reimbursement to lesser surgeries, forcing patients to choose to have a reconstruction that is more dangerous. Potter is certified by the American Board of Plastic Surgery (ABPS).

The following is a transcript of her remarks:

So breast reconstruction has been covered under the Women’s Health and Cancer Rights Act[WHCRA] since 1998. Breast reconstruction comes in a couple of different varieties: using an implant or using your …