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Name of the Procedure:
Breast Prosthesis, Mastectomy Form
Common Name: Breast Form
Technical Term: HCPCS Code L8020
Summary
A breast prosthesis, mastectomy form, is an artificial breast form used after mastectomy surgery to provide the appearance of a natural breast. It is worn inside a bra or attached to the chest wall and aims to restore balance and symmetry to the chest area.
Purpose
This procedure addresses the aesthetic and psychological impacts of losing a breast due to mastectomy. The goal is to help individuals regain confidence, restore body symmetry, and improve quality of life.
Indications
- Post-mastectomy patients
- Individuals with breast deformities or asymmetry
- Patients not eligible or opting out of breast reconstruction surgery
Preparation
Patients are encouraged to:
- Consult a certified mastectomy fitter for proper sizing
- Discuss their options and preferences with their healthcare provider
- Bring a supportive, well-fitted bra to fittings
Procedure Description
- Consultation: Meeting with a certified mastectomy fitter to discuss options.
- Fitting: Placing the breast prosthesis inside the bra to ensure proper fit and comfort.
- Adjustment: Customization of the prosthesis for size, shape, and skin tone if necessary.
- Education: Instructions on how to wear, care for, and maintain the breast form.
Tools: Soft measuring tape, assortment of breast forms. Technology: None required. Anesthesia: Not applicable.
Duration
The fitting session typically lasts about 30 minutes to 1 hour.
Setting
- Outpatient clinic
- Specialty prosthesis shop
Personnel
- Certified mastectomy fitters
- Breast care specialists
Risks and Complications
Common Risks:
- Skin irritation or allergic reaction
- Discomfort or improper fit Rare Risks:
- No surgical or procedural risks as it is a non-invasive solution
Benefits
- Restored body symmetry
- Improved self-esteem and body image
- Enhanced clothing fit and comfort Benefits may be realized immediately after fitting.
Recovery
There's no recovery period since the prosthesis fitting is non-invasive. Patients are advised to:
- Follow care instructions to maintain the prosthesis
- Schedule regular follow-up fittings if necessary
Alternatives
- Breast Reconstruction Surgery:
- Pros: Permanent solution, natural look and feel.
- Cons: Surgical risks, longer recovery, higher costs.
- Padding or lightweight forms:
- Pros: Less expensive, easy to use.
- Cons: May not provide the same level of realism or comfort.
Patient Experience
Most patients report a sense of relief and increased confidence after receiving their prosthesis. Comfort is generally high, with minimal discomfort. Pain management is typically unnecessary as this is a non-surgical procedure. Comfort measures include choosing a well-fitted bra and gradually getting accustomed to wearing the prosthesis.
Medical Policies and Guidelines
Related policies from health plans
L8020 policy automation walkthrough
Walk through the policies, prior authorization requirements, and workflow automation opportunities connected to this code.