CMS Announces It Will Retain Breast Reconstruction Codes, A Reversal That Protects Patient Access to DIEP Flap Surgery
Yesterday, the Centers for Medicare and Medicaid Services (CMS) announced that it will retain procedure codes for breast cancer reconstruction, after hearing feedback from NCCS and other patient advocates, patients, and health care professionals.
NCCS asked CMS to retain the S codes for breast reconstruction, so that people in need of breast reconstruction have access to DIEP flap procedures. DIEP flap is an important reconstruction option for individuals who choose reconstruction with their own tissue, rather than breast implants. The plan to eliminate certain breast reconstruction codes was creating real barriers to care for individuals seeking access to medically appropriate breast reconstruction after a cancer diagnosis.
NCCS actively advocated for this change and partnered with other patient advocacy organizations and the Community Breast Reconstruction Alliance, led by microsurgeon Dr. Elisabeth Potter, to share with CMS the access challenges that were resulting from the plan to eliminate the codes.
- In the spring, NCCS drafted a letter to CMS, which was signed by 34 patient advocacy organizations, 12 medical professional societies, and 231 health care professionals, including hospitals, practices, and individual health care providers. We also shared with CMS a petition with more than 4,600 signatures.
- In May, NCCS and the Community Breast Reconstruction Alliance met with CMS leadership to detail our concerns about access to care.
- On June 1, CMS hosted a public meeting, in which they sought input on its decision to sunset the S code. NCCS CEO Shelley Fuld Nasso spoke at the public meeting and urged CMS to retain the codes.
- In June, STAT News published an op-ed by NCCS Board Vice Chair Lisa D. T. Rice on the threat to access of DIEP flap breast reconstruction surgery.
“We are grateful to CMS for listening to patients, patient advocates, and health care professionals and changing course to protect access to breast reconstruction. This is a huge victory that would not have been possible without the tireless advocacy of so many people – patients, advocates, and health care providers. It is a testament to advocacy and sharing our collective voices for change,” said Fuld Nasso.
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Read More About NCCS’s Advocacy to Protect Access to DIEP Flap Surgery
NCCS Board Member in STAT News Op-Ed: CMS must protect access to the ‘gold standard of breast reconstruction’
STAT News recently published an op-ed by NCCS Board Vice Chair Lisa D. T. Rice on the threat to access of DIEP flap breast reconstruction surgery. In 1983, I flew home from college to be with my mother as she woke up from a mastectomy. She opted out of breast reconstruction, choosing to “go flat” […]
NCCS Urges CMS to Preserve Access to DIEP Flap Breast Reconstruction
Today, the Centers for Medicare and Medicaid Services (CMS) hosted a public meeting, in which they sought input on its decision to sunset the S code for deep inferior epigastric perforator (DIEP) flap reconstruction. NCCS has engaged in advocacy, along with other patient advocacy organizations and health care providers, to encourage CMS to reinstate the codes. The decision to end […]
NCCS Urges Insurance Companies to Preserve Access to DIEP Flap Breast Reconstruction
This week, NCCS joined other patient advocacy organizations and medical professional societies in submitting a letter to the CEOs of major insurance companies, expressing concerns with recent insurance coverage policy changes that have limited access to DIEP flap breast reconstruction surgery. Specifically, the letter asks these insurance companies to engage with individuals who have received […]
Lisa Rice – My Breast Cancer Journey: Many Lessons Learned and More in Store
During my final semester of college, a life-changing call came. My mother was in the hospital, waiting for results of a biopsy of a tumor she’d found in her breast. My father told me that she’d already decided, if the tumor was malignant, she would proceed with a radical mastectomy […]
NCCS Joins With Patient Advocates and Health Care Professionals to Call on CMS to Ensure Access to DIEP Flap Breast Reconstruction
WASHINGTON, DC, April 3, 2023 – Advocates for individuals in need of breast reconstruction surgery delivered a letter and petition to the Centers for Medicare and Medicaid Services (CMS) today, urging them to reinstate a procedure code that is essential for access to deep inferior epigastric perforator (DIEP) flap breast reconstruction surgery. More than 4,600 […]
NCCS Advocates for Access to DIEP Flap Breast Reconstruction Surgery
The National Coalition for Cancer Survivorship recently joined the Community Breast Reconstruction Alliance (CBRA), a group of patient advocacy organizations and health care providers who are working together to advocate for access to deep inferior epigastric perforator (DIEP) flap breast reconstruction surgery. Patient education regarding breast reconstruction includes a review of options, including breast reconstruction […]
