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

HCPCS code

Medical Policies and Guidelines for Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type

Related policies from health plans

Breast Reconstruction Following Mastectomy or Lumpectomy - (0178)

Similar Codes


ICD10CM codes

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
Z44.30 - Encounter for fitting and adjustment of external breast prosthesis, unspecified breast
Z45.819 - Encounter for adjustment or removal of unspecified breast implant
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
Z42.1 - Encounter for breast reconstruction following mastectomy
T85.43XA - Leakage of breast prosthesis and implant, initial encounter

HCPCS codes

L8001 - Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any
L8002 - Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any
L8000 - Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type
L8020 - Breast prosthesis, mastectomy form
L8015 - External breast prosthesis garment, with mastectomy form, post mastectomy
L8035 - Custom breast prosthesis, post mastectomy, molded to patient model
L8010 - Breast prosthesis, mastectomy sleeve
L8030 - Breast prosthesis, silicone or equal, without integral adhesive
L8032 - Nipple prosthesis, prefabricated, reusable, any type, each
L8600 - Implantable breast prosthesis, silicone or equal

CPT4 codes

19303 - Mastectomy, simple, complete
19342 - Insertion or replacement of breast implant on separate day from mastectomy
19325 - Breast augmentation with implant
77061 - Diagnostic digital breast tomosynthesis; unilateral
19499 - Unlisted procedure, breast
19340 - Insertion of breast implant on same day of mastectomy (ie, immediate)
77055 - Mammography; unilateral
19370 - Revision of peri-implant capsule, breast, including capsulotomy, capsulorrhaphy, and/or partial caps
19361 - Breast reconstruction; with latissimus dorsi flap
19364 - Breast reconstruction; with free flap (eg, fTRAM, DIEP, SIEA, GAP flap)