I returned from the American Society of Reconstructive Microsurgeons’ meeting late Tuesday this past week on January 24, 2023. What has been happening in the world of access to care and choice in breast reconstruction has shattered many of us in this community. There are many passionate surgeons who have dedicated their lives to performing the DIEP flap surgery. Patients affected are dismayed at coding changes and what is being taken away from the breast cancer community.
The Coding Changes and What is Being Taken Away
DIEP flap surgery is not going away. It is access to care thereby limiting our choice of what type of reconstructive surgery breast cancer patients can choose after mastectomy and loss of breast. The process of why these codes have been taken away, the S-code, is a complex system and decision process made by medical governing organizations. It involves evaluation of work hours spent by a physician and the complexity of a surgical procedure.
I am going to assume most patients who have had DIEP flap or are planning to have any autologous breast reconstruction have no knowledge of this complex process. Why should they? They are fraught with the emotional burden of making decisions about loss of breasts, treatment, and beating all odds of survivorship.
However, over the past couple of weeks, I researched, studied, and examined some of this process through the generosity of those involved in this system. This includes surgeons and practice managers at surgeons’ offices. It is a staggering and mind-bending amount of information for me to absorb and try to make sense of. This is only one article I read in the past week that the readers can check out themselves.
Feeling Personally Dismayed
My interest in understanding this complex decision process was to see both sides, the patient, and the surgeon. I amassed several hours at ASRM, on the phone after I returned home, via emails, and personal time on the internet. As I tried desperately to make sense of the coding changes and why it is seemingly happening before our eyes, I realize this has been a process occurring over the past few years. I wanted to be the voice for patients in an informed way.
It is a job larger than I can handle and I have come to realize that. What I consistently hear is that now more than ever, we need to hear the patient perspective. Our stories, why we had DIEP flap surgery or desire to make this surgical choice, is important to share with decision makers at the legislative level.
How Can You Help As a Breast Cancer Patient
I am leaning on those who have helped me the past couple of weeks. They have set up websites for patients to contact state representatives to tell your story and voice your concern. This list is for your reference. I cannot do any better job than what they have done. A personal note of gratitude goes out to the follow organizations and individuals. Please check out more information. I am providing their links here.
- PRMA Plastic Surgery ~ Blog, “Join the Fight”
- Dr. Minas Chrysopoulo, MD, FACS ~ Explanation of Coding Changes
- Dr. Elisabeth Potter, M.D. ~ Advocacy Page
- Dr. Jamie Zampell, M.D. ~ Advocacy Page
- Dr. Dhivya R Srinivasa, MD, FACS ~ Advocacy Page
- BreastCancer.org ~ Blog and Where you can help.
The Voice of Advocacy for Coding Changes
I leave you with this quote from the reconstructive surgeon who performed my DIEP flap breast reconstruction surgery in December of 2014. Make no mistake, this humanitarian has stood beside me as a surgeon, mentor, and friend because educating patients about this complex choice in breast reconstruction is that important to him. Thank you, Kind Sir!
Ultimately, what good are your rights if you have no access?
Dr. Minas Chrysopoulo; President: PRMA Plastic Surgery; Founder/Developer: Breast Advocate App
