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Custom breast prosthesis, post mastectomy, molded to patient model

HCPCS code

Medical Policies and Guidelines for Custom breast prosthesis, post mastectomy, molded to patient model

Related policies from health plans

Breast Reconstruction Following Mastectomy or Lumpectomy - (0178)

Similar Codes

ICD10CM codes

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

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

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

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

T85.42 - Displacement of breast prosthesis and implant

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

N65.0 - Deformity of reconstructed breast

T85.43 - Leakage of breast prosthesis and implant

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

T85.41XD - Breakdown (mechanical) of breast prosthesis and implant, subsequent encounter

HCPCS codes

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

L8020 - Breast prosthesis, mastectomy form

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

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

L8010 - Breast prosthesis, mastectomy sleeve

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

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

C1789 - Prosthesis, breast (implantable)

L8600 - Implantable breast prosthesis, silicone or equal

CPT4 codes

19325 - Breast augmentation with implant

19303 - Mastectomy, simple, complete

19361 - Breast reconstruction; with latissimus dorsi flap

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

19366 - Breast reconstruction with other technique

19357 - Tissue expander placement in breast reconstruction, including subsequent expansion(s)

19300 - Mastectomy for gynecomastia

19304 - Mastectomy, subcutaneous

19340 - Insertion of breast implant on same day of mastectomy (ie, immediate)

21270 - Malar augmentation, prosthetic material