560-X-13-.16 External Breast Prostheses

Silicone Breast Form - L8030
Foam Breast Form - L8020
Mastectomy Bras - L8000
Perma-Form/unilateral - L8001
Perma-Form/bilateral - L8002

560-X-13-.16 External Breast Prostheses.

For surgeries to implant breast prostheses in a hospital inpatient setting, you pay the .
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HCPCS Code L8020 for Breast prosthesis, mastectomy form.



If you had a mastectomy, we carry post surgery camisoles for immediately after surgery until your doctor tells you are ready to be fitted for a breast prosthesis and mastectomy bra.

Breast Prosthetics and Accessories

Or you can all the customer service number on the back of the card and use the HCPCS codes below to ask if your insurance covers these items and how many per year you are eligible for?
L8000 post-mastectomy bras
L8015 post mastectomy surgery camisole
L8020 foam breast form
L8030 silicone breast form

Breast prostheses can be worn in either amastectomy bra or a regular fashion bra.
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L8020-Breast Form; L8030-External Silicone Breast Prosthesis;

If Medicare is your primary insurance: In order to qualify for partial Medicare reimbursement, a licensed physician or other licensed healthcare professional, qualified, and eligible to order breast prostheses and other related post-mastectomy products must prescribe the items you are ordering. Jodee will request all necessary documentation, directly from your physician, to assist you in obtaining partial Medicare reimbursement upon your order.

breast prosthesis, mastectomy form

The removal or partial removal ofthe breast and/or the axillary lymphnodes is a common surgery for womenwith breast cancer. Your skin can besensitive after surgery and radiation, andthe slightest pressure on the chest wallmay cause irritation. You may receivea lightweight foam prosthesis with afront closure surgical bra to accommodatethe chest wall and begin to restorethe natural shape and contour of yourbreast. There are also camisole stylesavailable to accommodate the prosthesis.

LCD for External Breast Prostheses ..

covers external breast prostheses (including a post-surgical bra) after a mastectomy. covers surgically implanted breast prostheses after a mastectomy if the surgery takes place in an inpatient setting. Part B covers the breast reconstruction surgery if it takes place in an outpatient setting.

Breast prosthesis, silicone or equal, without integral adhesive

(1) Effective June 1, 2001, external breast prostheses following mastectomy for breast cancer are covered for all Medicaid-eligible recipients meeting the criteria.

2017 HCPCS Codes > L Codes > L8020

If you are covered by Medicare, you are allowed:
• One silicone breast form every 2 years (2 forms for bilateral surgery)
- OR -
• One Perma-Form Bra every six months
- OR -
• One foam breast form every 6 months (2 for bilateral surgery)
- AND -
• As many mastectomy bras as are deemed reasonable and necessary