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MEDTECH DIEP flap has been found to result in better patient well-being, fewer complications, and quicker recovery with less hospitalization time compared to muscle-based procedures.
As the landscape of breast reconstruction options evolves, one technique, DIEP flap, emerges as a compelling choice for many women post-mastectomy. However, the potential removal of its unique medical billing code by the Centers for Medicare and Medicaid Services (CMS) threatens access to this valuable procedure.
Key Points:
- The author chose DIEP flap reconstruction, regarded as “the gold standard for reconstructive options,” following her breast cancer diagnosis in 2017.
- CMS may end the medical billing code for DIEP flap at the request of insurance companies, limiting patient access to this reconstruction method.
- Breast implants, the most common alternative to natural reconstruction, pose various health risks and aren’t suitable for everyone.
- Since the establishment of a reimbursement code for DIEP flap by CMS in 2006, access to the procedure has increased, allowing fair compensation for this complex procedure.
Additional Points:
- Insurance reimbursement rates for breast implants are typically higher than for natural reconstruction methods, making them more lucrative for surgeons.
- Women’s access to breast reconstruction increased by 36% within two years of the Women’s Health and Cancer Rights Act (WHCRA) becoming law, and a further increase of 62% was observed between 2009 and 2014 in at least 22 states.
- The removal of the DIEP flap billing code could result in fewer surgeons offering it as an option, making it inaccessible for most patients who need breast reconstruction.
Conclusion:
- Preserving the DIEP flap reimbursement code is vital for ensuring patient access to this crucial reconstruction option, leading to better patient outcomes. Without it, many patients may face limited access to their preferred reconstruction method, increasing the burden on those already dealing with cancer.
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“We have our hands full dealing with cancer. We shouldn’t have to fight to keep a benefit we’ve had for nearly two decades, one which is a vital part of quality care.”
Lisa D. T. Rice
Breast Cancer Survivor and Vice Chair of the National Coalition for Cancer Survivorship
