Reconstructive Breast Surgery. Benefits will be provided for reconstructive breast surgery resulting from a Mastectomy.
A. Reconstructive breast surgery means surgery performed as a result of a Mastectomy to reestablish symmetry between the two breasts. Reconstructive breast surgery includes:
1. Augmentation mammoplasty;
2. Reduction mammoplasty; and
3. Mastopexy.
B. Benefits are provided for all stages of reconstructive breast surgery performed on the non-diseased breast to establish symmetry with the diseased breast when reconstructive breast surgery on the diseased breast is performed.
C. Benefits are provided regardless of whether the Mastectomy was performed while the Member was covered under the Agreement.
D. Coverage will be provided for treatment of physical complications at all stages of Mastectomy, including lymphedemas, in a manner determined in consultation with the Member and the Member’s attending physician.
Reconstructive Breast Surgery. All stages of Reconstructive Breast Surgery after a mastectomy including, but not limited to:
Reconstructive Breast Surgery. Reconstructive breast surgery resulting from a mastectomy is covered. Coverage includes reconstruction of the breast on which the mastectomy is performed including areolar reconstruction and the insertion of a breast implant; surgery and reconstruction performed on the non-diseased breast to establish symmetry when reconstructive breast surgery on the diseased breast has been performed; and Medically Necessary physical therapy to treat the complications of mastectomy, including lymphedema.
Reconstructive Breast Surgery. A. Definitions
Reconstructive Breast Surgery. Surgery performed as a result of a mastectomy to reestablish symmetry between the breasts. The term includes augmentation mammoplasty, reduction mammoplasty, and mastopexy. A bed occupied in an Outpatient surgical center for less than 24 hours by a patient recovering from surgery or other treatment. A facility, or a designated unit of a facility, licensed, certified or accredited to provide Rehabilitation Therapy including:
Reconstructive Breast Surgery. Benefits will be provided for reconstructive breast surgery resulting from a Mastectomy performed as a result of breast cancer. Mastectomy means the surgical removal of all or part of a breast as a result of breast cancer.
A. Reconstructive breast surgery includes:
1. Augmentation mammoplasty;
2. Reduction mammoplasty; and
3. Mastopexy.
B. Benefits are provided for all stages of reconstructive breast surgery performed on the non-diseased breast to establish symmetry with the diseased breast when reconstructive breast surgery on the diseased breast is performed.
C. Benefits are provided regardless of whether the Mastectomy was performed while the Member was covered under the Evidence of Coverage.
X. Xxxxxxxx will be provided for prostheses for a Member who has undergone a Mastectomy as well as services resulting from physical complications at all stages of Mastectomy including lymphedema.
Reconstructive Breast Surgery. We cover reconstructive surgery to correct significant deformities caused by congenital or developmental abnormalities, illness, injury or an earlier treatment in order to create a more normal appearance. Benefits include surgery performed to restore symmetry after a mastectomy. Reconstructive services needed as a result of an earlier treatment are covered only if the first treatment would have been a Covered Service under this Plan.
