endstream It takes expertise and experience with breast reduction surgery to know ahead of time the amount of tissue that will need to be taken from each breast. breast tissue removed fall below the lower 22nd percentile, then the surgery is deemed not medically necessary. This study was not designed for what insurance companies use it for. Quick Calculation of Breast Resection Mass Using the Schnur Average weight of tissue planned to be removed in each breast, is above the 22nd percentile on the Schnur Sliding Scale based on the patient's body surface area (BSA) This Schnur chart may be used to assess whether the amount of tissue (per breast) that will be removed is reasonable for the body habitus, and whether the procedure is cosmetic The most reliable method for evaluating your eligibility for breast reduction is the Schnur Sliding Scale, which allows Dr. Omidi to determine the right tissue amount to be removed from each breast. In determining the medical necessity of . endstream endobj 353 0 obj <. PMID: 1952749 . Federal government websites often end in .gov or .mil. How many cup sizes can a breast reduction remove? HVM@+QVQ*9PeK`U0$AD?#T]:"(kcp]'u_sngA05]}+OR2=Rf0UC>>]!8=J Insurance companies took this information, created a chart based on the 22nd percentile, and use it to deny all procedures that don't meet that. The goal of medically necessary breast reduction surgery is, Is the breast reduction procedure painful? Search for Similar Articles Will you still be able to buy Godiva chocolate? By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. How accurate is the Schnur Sliding Scale? : r/Reduction - Reddit 1999 Jan;42(1):107-8. . reason or as a medically necessary procedure. Schnur pointed out that if a payer used weight of resected tissue as a coverage criterion, then if the weight fell below the 5th percentile, the reduction mammaplasty would be considered cosmetic; if above the 22nd percentile, it would be considered medically necessary; and if between these cutpoints, it would be considered on a case-by-case basis. Putting $19,000 in my 403(b) retirement bucket prevents Uncle Sam from taxing it in 2019, thus deferring $4,180 in taxes for 2019. DDD cups usually weigh around, Answer: Removal of 500 Grams on Each Side Would Most Likely Result in a, A 900 gm reduction would be equivalent to, The ideal time for a breast reduction is once the breasts have stopped growing, usually, A breast reduction is a common procedure that will take. The patients body surface area and average weight of breast tissue removed is incorporated into this chart. doi: 10.1097/SAP.0000000000001885. hb```-y eaX&pSa )FIw-~'/AHD zn@Z%201fgiS1JLYLnL}ySU cx$cP10-^ A breast reduction surgery is deemed medically necessary if the patient's body surface area and weight of breast tissue removed are above the 22nd percentile. %PDF-1.5 % This effect is especially marked in women who have a smaller frame and a bigger bust. etic reasons, for mixed reasons, and for purely medical reasons, 132 of the same 220 surgeons responded. 0000000935 00000 n If the patient's body surface area and weight of breast tissue removed fall below the 22nd percentile, then the surgery is deemed cosmetic in nature, and therefore not medically necessary. e`TacraLZ,7Hc,`9?b="`pl-e5f hVp"n mg+V@2Xd`Mj^ ` &6 Schnur PL. 0000006152 00000 n If the individual's body surface area and weight of breast tissue removed fall below the 22nd percentile, then the surgery is not medically necessary. Privacy Policy. E-mail: [emailprotected]. They presented a very cogent argument for selecting three groups of patients: those with medica This chart compares the quantity of removed breast tissue to your body surface area. Plast Reconstr Surg. Ann Plast Surg. In 1991, Dr Paul Schnur and his colleagues published an article correlating the weight of breast tissue to be removed in a breast reduction operation with the total body surface area (BSA) of the patient. 0000000998 00000 n Where is the mitochondria located and what is its function? 0000003061 00000 n The .gov means its official. To convert pounds to kilograms, multiply pounds by 0.4536. rmLK#43P8 %tL G-< 11.16 PLASTIC SURGERY REFERRAL GUIDELINES Contracted Group: Nevada Plastics Ml amount of tissue to be removed from either breast be greater than or equal to the 22nd percentile on the Schnur Scale? To convert inches to centimeters, multiply inches by 2.54. If the amount plots above the 22ndpercentile and the member has a Functional Impairment, the procedure is reconstructive. The authors concluded that the surgeries where the individual's BSA and the weight of tissue removed was above the 22nd percentile were all for reconstructive reasons, those below the 5th percentile were entirely cosmetic, and the ones that fell between were a mix of both and needed to be evaluated individually to determine which one they fell into. How do you use Square reader for the first time? and our Average weight of tissue planned to be removed in each breast is above the 22nd percentile as referenced on the Schnur Sliding Scale based on the individual's body surface area (BSA) below: . 1. breast reduction, insurance, nomogram, reduction mammaplasty, reimbursement, sliding-scale, Schnur, surface area. Schnur Sliding Scale (SSS) Calculation of Body Surface Area (BSA), as shown in the following (using centimeters for height and kilograms for weight): BSA = the square root of ( [height x weight] 3600). PDF Cigna Medical Coverage Policy - AAPC 218: 1.45: 238 . What is the best time to treat for grubs? The Schnur scale So far so good Average weight of tissue planned to be removed in each breast is above the 22nd percentile as referenced on the Schnur Sliding Scale based on the individual's body surface area (BSA). MeSH and all women whose breast weight was greater than the 22nd percentile sought the procedure for medical reasons. While this practice continues, our simplified Schnur Sliding Scale nomogram is meant to help easily determine the insurer-required minimum breast resection weight and thereby both improve patient counseling prior to planning surgery and assist the surgeon with achieving insurer reimbursement for the procedure while avoiding rejected claims. This calculator yields the required weight of tissue to remove with just knowledge of the patient's height and weight and the use of a straight edge. O@ This chart compares the quantity of removed breast tissue to your body surface area. 0 (See Appendix for the Schnur Sliding Scale.) Those women whose removed breast tissue weight was between the 5th and the 22nd . Redefining the Role of Resection Weight Prediction in Reduction Mammaplasty and Breaking the "One-Scale-Fits-All" Paradigm. PDF Breast Reduction - Cigna PDF 703 Reduction Mammaplasty %%EOF 1340 0 obj PDF 703 Reduction Mammaplasty - Blue Cross Blue Shield of Massachusetts If the individual's body surface area and weight of breast . What size would I become if the 527 grams were removed . Schnur pointed out that if a payer used weight of resected tissue as a coverage criterion, then if the weight fell below the 5th percentile, the reduction mammaplasty would be considered cosmetic; if above the 22nd percentile, it would be considered medically necessary; and if between these cutpoints, it would be considered on a case-by-case basis. The https:// ensures that you are connecting to the 22nd percentile breast reduction - Cosmetic Surgery Tips This Schnur chart may be used to assess whether the amount of tissue that will be removed is reasonable for the body habitus, and whether the procedure is cosmetic or reconstructive in nature. tissue that is planned to be removed in each breast above the 22nd percentile on the Schnur Sliding Scale (see Appendix) based on the individual's body surface . You can read the full text of this article if you: Keywords 0000007705 00000 n (1991) concluded that women whose removed breast weight was less than the 5th percentile sought the procedure for cosmetic reasons and all women whose breast weight was greater than the 22nd percentile sought the procedure for medical reasons. 1362 0 obj If the amount plots above the 22nd percentile, and other cocriteria are met, breast reduction would be allowed; 2. Schnur Sliding Scale for Breast Reduction - RealSelf.com ;3@r&@Dh8 -r Lower 5% Lower 22% 1.35 127 199 1.40 139 218 1.45 152 238 1.50 166 260 1.55 181 284 1.60 198 310 . was greater than the 22 nd percentile, a woman's motivation for the surgery was medical, and if the removed breast . If the amount plots above the 22nd percentile and the member has a Functional Impairment, the procedure is reconstructive. Everything we do is designed to help our patients achieve their desired results. Dr. Cohen must also understand ahead of time the amount of tissue removed that he believes a patients insurance company will use as a further criterion to consider the procedure medically necessary. Policy Number : MP.004.24 Effective Date: April 1, 2023 Instructions for Use A Schnur sliding scale percentile was also calculated for all patients. Ann Plast Surg. While this practice continues, our simplified Schnur Sliding Scale nomogram is meant to help easily determine the insurer-required minimum breast resection weight and thereby both improve patient counseling prior to planning surgery and assist the surgeon with achieving insurer reimbursement for the procedure while avoiding rejected claims. utilizing this scale, Schnur et al. Found it! Schnur Scale 5th percentile : r/Reduction - Reddit be removed to meet the 22 nd percentile where women are likely to have a reduction mammaplasty primarily for medical reasons. MEDICAL POLICY STATEMENT - CareSource Please click OK to confirm you are at least 18 years of age and are not offended by this material. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); We are largest Know-How Listing website, total [total_posts] questions already asked and get answers instantly! endobj AbstractBackground. endstream endobj startxref My insurance says the amount of tissue removed has to be greater than 22 percentile on Schnur Scale. The original paper it was based on was published in 1991 and consisted of sending questionnaires to 200 plastic surgeons and asking them to give their opinion on the last 15-20 reductions they had performed as to whether they were cosmetic or reconstructive (medically necessary). He determined that women who fell above the 22nd percentile line were motivated for medical reasons and those below the 5th percentile were motivated by cosmetic reasons. Multiply your height by your weight, 17060 = 10200 ; Divide the result by 3600, 10200/ 3600 = 2.8 ; Find the square root of the result, SQRT 2.8 = 1.67 . 7.01.21 Reduction Mammaplasty for Breast-Related Symptoms Plast Reconstr Surg. The Schnur . 391 0 obj <>stream This method was developed by a plastic surgeon for use in a study to determine the number of women who had breast reduction surgery for medical reasons only. New comments cannot be posted and votes cannot be cast. How do I backup my iPhone when I get a new one? Save my name, email, and website in this browser for the next time I comment. 0000044323 00000 n Ann Plast Surg. 300 grams per breast for women with height less than 5'2" or weight less than 120 lbs. My insurance says the amount of tissue removed has to be greater than 22 percentile on Schnur Scale. Reduction mammaplastythe Schnur sliding scale revisited. I looked at the Schnur scale table and base on my weight and body surface area (1.41-1.45) the threshold value per breast for me would be 238 per breast. This Schnur chart may be used to assess whether the amount of tissue (per breast) that will be removed is reasonable for the body habitus, and whether the procedure is cosmetic or reconstructive in nature. modify the keyword list to augment your search. While this practice continues, our simplified Schnur Sliding Scale nomogram is meant to help easily determine the insurer-required minimum breast resection weight and thereby both improve patient counseling prior to planning surgery and assist the surgeon with achieving insurer reimbursement for the procedure while avoiding rejected claims. Should I be worried if I have silverfish? 1. I previously posted asking if anyone knew how to find the 5th percentile on the Schnur scale. Twenty-four of the 85 patients (28%) were below the 22nd percentile on the Schnur scale normogram, indicating that their procedure would be classified as "cosmetic". Your weight should be stable. You can calculate your BSA (body surface area) here. Body surface area, along with average How much does 500 grams of breast tissue weigh? 0000013559 00000 n <> Reduction mammaplasty is a common procedure associated with a very high patient satisfaction rate. 0000001370 00000 n 39 21 Dvoracek, Lucas A. MD; Gusenoff, Jeffrey A. MD; Peter Rubin, J. MD; Manders, Ernest K. MD. Are poem titles italicized or underlined? Posted on 9 June 2022 Author is bob delaurentis related to dino de laurentiis . PDF Reduction Mammaplasty BACKGROUND - American Society of Plastic Surgeons Those women whose removed breast tissue weight was between the 5th and the 22nd percentiles . percentile, the breast reduction would be considered cosmetic; if above the 22nd percentile, it would be considered medically necessary; and if between these cutpoints, it would be considered on a case-by-case basis. How do you search old text messages on iPhone? Can anyone help explain the Schnur scale? : r/Reduction - Reddit Dr. Cohen uses the Schnur Sliding Scale to help patients determine if their breast reduction is medically necessary and then present the proper information to insurance companies. endobj %PDF-1.4 % This patient is a 42 year old female who requested a consult at my facility due to problems with oversized breasts. Asked By: Mom-To-4 in North Carolina. What does the Bible say about overflowing? P L Schnur 1 , J G Hoehn, D M Ilstrup, M J Cahoy, C P Chu. Asked By: Mom-To-4 in North Carolina. doi: 10.1097/PRS.0000000000009536. Accessibility 0000004621 00000 n sharing sensitive information, make sure youre on a federal If the individual's body surface area and weight of breast tissue removed fall below the lower 22nd percentile, then the surgery . doi: 10.1097/PRS.0000000000005712. J}pqmMJIo+\=w[`%&>A Q("X@J8]\A What that chart showed is that people who were above the 22nd percentile had gotten the surgery for "primarily medical reasons, and people above the 6th percentile got the surgery for "mixed medical and cosmetic reasons". 0000041762 00000 n and all women whose breast weight was greater than the 22nd percentile sought the procedure for medical reasons. endobj xref 1341 0 obj What BMI do you need for breast reduction? The commonly used Schnur Sliding Scale suggests that resection weights above the 22nd percentile should be regarded as reconstructive, while resection weights falling below the fifth percentile should be deemed cosmetic.8 However, from a scientific standpoint, the basis for developing this scale is flawed. See Appendix 1 2. The Schnur Sliding Scale chart is an evaluation method used with individuals who are considering breast reduction. This Schnur chart may be used to assess whether the amount of tissue (per breast) that will be removed is reasonable for the body habitus, and whether the procedure is cosmetic or reconstructive in nature. The Schnur Sliding Scale is widely used by insurance companies in the western United States in the process of preauthorizing breast reduction operations, and its use may be spreading eastward. your express consent. those with breast weight above the 22nd percentile line likely had the procedure performed for medical reasons, while those below the 5th percentile line likely had the procedure performed for cosmetic reasons, and those falling between the lines had the procedure formed for mixed reasons. The patient is a 41-year-old female who presented to my office with complaints of breasts which were larger than desired. Those women whose removed breast tissue weight was . How can I get my insurance to pay for breast reduction? July 21, 2009. If the amount plots Comparative Accuracy of Clinical and Formula-Based Estimation of Resection Weight in Reduction Mammoplasty and Implications for Insurance Preapproval and Payment, Privacy Policy (Updated December 15, 2022).