Valley woman tries to get insurance companies to cover breast implant removal

PHOENIX (3TV/CBS 5) — Although it can cost as little as $5,000 for breast implants, having them removed for a medical reason can cost triple that. Arizona’s Family has learned that most women who wish to have their breast implants removed for medical reasons will have their coverage denied.

In 2015, Melody Viscariello underwent mastectomy and implant surgery after battling breast cancer. She helped those who helped pass a new law in Arizona requiring people receiving breast implants to be given information about what could go wrong. This law entered into force this year.

After receiving the implants, she became the sickest she had ever been. Like most women with breast implant-related illnesses, she suffered from chronic fatigue, headaches, and joint and muscle pain. Although doctors validated her symptoms, she had to take out a loan to pay for the withdrawal and dedicated her life to spreading awareness about the disease.

Currently, insurance companies do not have a diagnosis code for breast implant disease and therefore no code is needed to have them removed. So now Viscariello is continuing his fight, focusing on gaining assurance to recognize the ICD code, which is needed to process payments electronically. For example, she says there is a code for a crushed toe but no code for breast implant removal.

“It’s so scary, imagine, and now you don’t have the funds to pull those debilitating bags out of your chest when you know that’s what it is now because there’s so much information medical now,” Viscariello said.

Helping patient advocates like Viscariello is Arizona plastic surgeon Dr. Raman Mahabir. He was instrumental in getting this law passed and is working with it again to bring about changes to the insurance process. But why is it refused? When the computer sees that there is no code for it, it is automatically denied by the insurance companies.

“There’s a code for I stub my right toe; there is literally a code that i stub my right toe. He puts it on and gets paid because he saw a medically necessary procedure. Currently, this does not exist for breast implant disease,” Mahabir said.

The duo made some progress. Viscariello ran a non-profit organization called “Just Explant”, raising funds for women who could not afford to pay to have their implants removed.

“Some of these women are reaching out to me saying, is there any way you can help me, can you help me get them out? That’s what my nonprofit is to help these women for the cost of getting them out,” Viscariello said. “We have good data, good evidence that shows women who are really sick, implants more often, get better. This is no longer up for debate. »

Kristan F. Talley