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Wiki Prophylactic breast removal in Texas

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jbuckendorf

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Weatherford, TX
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Hi. Can someone in Texas please tell me if Medicare pay for the removal of the breast prophylactically at the same time as removing the other breast for cancer? My doctor performed the surgery but the 2nd breast was denied by Medicare. We are in the Novitas guidelines and I can't find any sources or documentation one way or the other for reimbursement purposes.
 
Look at your diagnosis code one dx for breast cancer of L/R breast and one Z code for prophylactic Breast removal Z40.01. Maybe that will get it.

Charlotte
 
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