Gynecomastia Medical Necessity

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Gynecomastia | Johns Hopkins Medicine

https://www.hopkinsmedicine.org/health/conditions-and-diseases/gynecomastia

Gynecomastia is often caused by changes in levels of the female hormone (estrogen) and the male hormone (testosterone). But it can be caused by other things as well. Gynecomastia can be a side effect of certain medicines, such as antidepressants, …

Gynecomastia: Etiology, Diagnosis, and Treatment

https://www.ncbi.nlm.nih.gov/books/NBK279105/

Gynecomastia, breast development in males, can occur normally during three phases of life. The first occurs shortly after birth in …

Breast Reduction Surgery and Gynecomastia Surgery

https://www.aetna.com/cpb/medical/data/1_99/0017.html

Reduction mammoplasty has been performed to relieve back and shoulder pain on the theory that reducing breast weight will relieve this pain. For pain interventions, evidence …

Guidelines for Medical Necessity - mass.gov

https://www.mass.gov/doc/mastectomy-for-gynecomastia-2/download

Gynecomastia is an enlargement in the glandular tissue of the breast in males. It can occur physiologically (normally) in newborns, adolescents, and older men. Increase in fatty …

MassHealth Guidelines for Medical Necessity …

https://www.mass.gov/guides/masshealth-guidelines-for-medical-necessity-determination-for-mastectomy-for-gynecomastia

Guidelines for Medical Necessity Determination for Mastectomy for Gynecomastia. These Guidelines for Medical Necessity Determination (Guidelines) identify the clinical …

LCD - Cosmetic and Reconstructive Surgery (L35090)

https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=35090

If the individual's body surface area and weight of breast tissue removed fall above the 22nd percentile, then the surgery is considered medically reasonable and …

Billing and Coding: Cosmetic and Reconstructive Surgery

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=58573&LCDId=38914

The following ICD-10-CM codes support medical necessity and provide coverage for (CPT) codes: 15830, 15847, and 15877 for Abdominal Lipectomy/ …

Gynecomastia Surgery - Cigna

https://static.cigna.com/assets/chcp/pdf/coveragePolicies/medical/mm_0195_coveragepositioncriteria_surgical_treatment_of_gynecomastia.pdf

Gynecomastia is the benign proliferation of glandular breast tissue in males. It differs from proliferation of breast tissue in females in that there is no terminal alveolar development …

Medical Necessity Criteria and Clinical Review Guidelines

https://www.medmutual.com/For-Providers/Medical-Necessity-Criteria-and-Clinical-Review-Guidelines

Medical Necessity Criteria and Clinical Review Guidelines. Care Management uses nationally recognized and accepted utilization management criteria, as well as …

Medical Necessity Guidelines: Reconstructive and …

https://tuftshealthplan.com/documents/providers/guidelines/medical-necessity-guidelines/reconstructive-cosmetic

Medical Necessity Guidelines are developed to determine coverage for benefits and are published to provide a better understanding of the basis upon which …

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