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Breast prosthesis, mastectomy form

HCPCS code

Medical Policies and Guidelines for Breast prosthesis, mastectomy form

Related policies from health plans

Breast Reconstruction Following Mastectomy or Lumpectomy - (0178)

Breast Procedures (CG036)

Similar Codes

ICD10CM codes

Z42.1 - Encounter for breast reconstruction following mastectomy

Z44.32 - Encounter for fitting and adjustment of external left breast prosthesis

Z44.3 - Encounter for fitting and adjustment of external breast prosthesis

Z44.31 - Encounter for fitting and adjustment of external right breast prosthesis

T85.41XA - Breakdown (mechanical) of breast prosthesis and implant, initial encounter

T85.41 - Breakdown (mechanical) of breast prosthesis and implant

T85.42XA - Displacement of breast prosthesis and implant, initial encounter

Z44.30 - Encounter for fitting and adjustment of external breast prosthesis, unspecified breast

T85.43XA - Leakage of breast prosthesis and implant, initial encounter

T85.42 - Displacement of breast prosthesis and implant

HCPCS codes

L8020 - Breast prosthesis, mastectomy form

L8015 - External breast prosthesis garment, with mastectomy form, post mastectomy

L8010 - Breast prosthesis, mastectomy sleeve

L8002 - Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any

L8001 - Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any

L8035 - Custom breast prosthesis, post mastectomy, molded to patient model

L8000 - Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type

L8030 - Breast prosthesis, silicone or equal, without integral adhesive

L8600 - Implantable breast prosthesis, silicone or equal

C1789 - Prosthesis, breast (implantable)

CPT4 codes

19303 - Mastectomy, simple, complete

19304 - Mastectomy, subcutaneous

19342 - Insertion or replacement of breast implant on separate day from mastectomy

19300 - Mastectomy for gynecomastia

19325 - Breast augmentation with implant

19316 - Mastopexy

77062 - Diagnostic digital breast tomosynthesis; bilateral

19366 - Breast reconstruction with other technique

19305 - Mastectomy, radical, including pectoral muscles, axillary lymph nodes

19302 - Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); with axillary lympha