CPT code for Brava?

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pisces111
pisces111 Member Posts: 4
edited June 2014 in Breast Reconstruction

Hello!

Does anyone know what the CPT code is for the Brava device?

Thank you!

Comments

  • ells37
    ells37 Member Posts: 14
    edited June 2014

    Pieces try using these (you'll want to use all three).  This is what is listed in the Brava info site...

    19366: Breast Reconstruction

    15734: Muscle-Skin Graft, Trunk 
    15770: Derma-Fat-Fascia Graft

  • pisces111
    pisces111 Member Posts: 4
    edited June 2014

    Thank you, elliem6.

    I actually found this information as well after I made my post. However, I decided to try to call Brava directly and ask if they could provide a CPT code. I received a phone call back today saying that they cannot provide a code because "fat grafting is in the hands of the FDA right now."

    The reason I am seeking a CPT code is because my Medicaid provider said they will need the code in order to determine if the Brava is covered. In my initial consultation with my plastic surgeon, he told me that insurance never covers it, but I thought that I would just try to verify that on my own, with my own insurance coverage (Medicaid, WA state).

    I then decided to do a search on "fat grafting fda" and discovered this page!

    http://www.breastreconstructionandaugmentation.com...

    The article above states: "The FDA has now also approved the BRAVA® device as a class B device that
    is reimburseable by Medicare, and thus presumably by insurance
    companies."

    And thus also presumably by Medicaid?

    I called my doctor's office and read that statement to them. The woman taking my call was surprised by this and said that she would pass this info along to another person in the office who will be doing some research and calling me back. I am scheduled to begin this process in August, and I told her it would be nice to see what we can do between now and then to try to get Brava to be reimburseable. That article, by the way, was posted a little over a year ago! I wonder if RED TAPE is the only reason that reimbursement hasn't started happening for more women?

    I'll follow up on this question when I know more. I am going in, by the way, this Thursday to have a mastectomy, just the left breast.

  • pisces111
    pisces111 Member Posts: 4
    edited June 2014

    Here is another article stating the Brava is now reimburseable. I saw one dated April of last year saying that clinical studies were being postponed by the FDA, but in May of last year, this article and the one I posted above said that it was just a brief period of time that there was a question. I haven't been able to find anything since last year on the subject.

    http://www.laurengreenbergmd.com/breast/brava-back...

    Oh.... wait a minute..... the statement says the Brava is reimburseable to women "...so long as they are participants of the current clinical trials.”

    Hmmm... I'm not in a clinical trial.... drat.

  • ells37
    ells37 Member Posts: 14
    edited June 2014

    Good luck with your surgery! 

  • pisces111
    pisces111 Member Posts: 4
    edited June 2014

    Thank you, elliem6!

    I did hear back from my doctor's office. Yeah, it's not reimburseable if you're not in a clinical trial, and they are not recruiting new people for the trials at this time. Also, I probably wouldn't qualify because I weigh just a bit over their currently stated weight limit. They're supposed to end next May, and then, of course, there will have to be further approval processes. Sigh..... just a tad too early...... At least my doctor is willing to offer it to women as an option.

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