Breast Resection Weight Prediction and Insurance Reimbursement in Reduction Mammoplasty: Which Scale is Reliable?

Maria Yan, Samyd S Bustos, Doga Kuruoglu et al.
Breast Resection Weight Prediction and Insurance Reimbursement in Reduction Mammoplasty: Which Scale is Reliable?
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Many insurance companies in the United States rely on the Schnur Sliding Scale to predict resection weights to determine medical necessity for breast reduction surgery. Accurate methods to predict resection weights are needed to avoid insurance denials. Our aim is to compare the accuracy of formulas such as Schnur, Appel, Descamps and Galveston in predicting resection weights, and to assess if it influences insurance coverage decision.

A retrospective review of bilateral reduction mammoplasty procedures from June 2017-June 2019 was performed at Mayo Clinic, Rochester. Oncoplastic reduction surgeries were excluded. The accuracy of each formula-based estimate was evaluated with linear regression analysis.

The Schnur scale is a poor predictor of breast resection weight. Appel is the most accurate estimator, especially in the young and obese population with larger resections.

Read full article here: https://pubmed.ncbi.nlm.nih.gov/35862075/ 

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