0000010953 00000 n Boukovalas S, Padilla PL, Spratt H, Tran JP, Li RT, Boson AL, Howland N, Phillips LG. The Schnur Sliding Scale chart is an evaluation method used with individuals who are considering breast reduction. 11.16 PLASTIC SURGERY REFERRAL GUIDELINES Contracted Group: Nevada Plastics By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. I looked at the Schnur scale table and base on my weight and body surface area (1.41-1.45) the threshold value per breast for me would be 238 per breast. %%EOF Original Policy Date: December 1995 Page: 2 MP 7.01.21 Reduction Mammaplasty for Breast-Related Symptoms Requirement of a specified amount of breast tissue to be resected, commonly 500 to 600 grams per breast. The goal of medically necessary breast reduction surgery is, Is the breast reduction procedure painful? I couldn't find information on the 5th percentile anywhere. This patient had all of the classic symptoms of oversized breasts including neck pain, back pain, bra strap grooving, shoulder discomfort, and difficulty with physical activity Average grams of tissue per breast to be removed, LEARN MORE ABOUT BREAST REDUCTION SURGERY, 465 N Roxbury Dr., Suite 750Beverly Hills, CA 90210, Dr. Cohen's Perspective: Breast Augmentation & Enhancement, You can calculate your BSA (body surface area) here. 0 Where does the Tail of the Dragon start and end? A 500 gm reduction from each breast amounts to a 2.2 pound total weight reduction. <<8CD364E2581BCE4D970CF038F561BF58>]/Prev 172982>> In a survey of plastic surgeons, Schnur et al. Schnur Sliding Scale for Breast Reduction. O@ 1999;42:107-8. New comments cannot be posted and votes cannot be cast. Should You Have Breast Reduction When You Are Overweight? breast reduction, insurance, nomogram, reduction mammaplasty, reimbursement, sliding-scale, Schnur, surface area. Comparative Accuracy of Clinical and Formula-Based Estimation of Resection Weight in Reduction Mammoplasty and Implications for Insurance Preapproval and Payment. Is above the 22nd percentile on the Schnur Sliding Scale. Everything we do is designed to help our patients achieve their desired results. Reprints: Lucas A. Dvoracek, MD, 3550 Terrace St, 6B Scaife Hall, Pittsburgh, PA 15261. <>/Filter/FlateDecode/ID[<111BBA71CC41E248B79D71C8D461440C><95A3D44477B5B2110A00A061DAF3FF7F>]/Index[1340 35]/Info 1339 0 R/Length 107/Prev 353785/Root 1341 0 R/Size 1375/Type/XRef/W[1 3 1]>>stream For example, the familiar Schnur sliding scale was devised as a nomogram that relates resected breast weight to body surface area and defines surgeries resulting in resection weights above the 22nd percentile as being reconstructive, whereas those below the fifth percentile as cosmetic. Lower 5% Lower 22% 1.35 127 199 1.40 139 218 1.45 152 238 1.50 166 260 1.55 181 284 1.60 198 310 . (1991) determined that women whose removed breast weight was above the 22nd percentile were likely to receive the procedure for medical reasons. The commonly used Schnur Sliding Scale suggests that resection weights above the 22nd percentile should be regarded as reconstructive, while resection weights falling below the fifth percentile should be deemed cosmetic.8 However, from a scientific standpoint, the basis for developing this scale is flawed. 22. philadelphia events may 2022. MeSH He uses the Schnur Sliding Scale to help him determine these factors with integrity and proper judgment. Taken from the Schnur Sliding Scale . Documentation of patient's body surface area (BSA), based on the Schnur Sliding Scale (SSS), in which the patient's breast weight (per breast) is estimated at greater than the 22nd percentile line Refer to SSS and calculation of BSA at the end of the Rationale Section) consisting of breast tissue, not fatty tissue to be removed. Wampler AT, Powelson IA, Homa K, Freed GL. In determining the medical necessity of . If r is an integer then the data value at location r, x r, is the percentile p: p = x r. since if ri = r and is an integer then rf does not exist or rf . If the amount plots above the 22nd percentile and the member has a Functional Impairment, the procedure is reconstructive. %PDF-1.5 % The patient is a 41-year-old female who presented to my office with complaints of breasts which were larger than desired. Your message has been successfully sent to your colleague. trailer Do I need to take my dog to the vet if he has fleas? The Schnur Sliding Scale is widely used by insurance companies in the western United States in the process of preauthorizing breast reduction operations, and its use may be spreading eastward. This Schnur chart may be used to assess whether the amount of tissue that will be removed is reasonable for the body habitus, and whether the procedure is cosmetic or reconstructive in nature.
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