umentation of patient's bod


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. 1.1 Large breast size in relation to body, requiring removal of an average weight of tissue that is planned to be removed in each breast above the 22nd percentile on the Schnur Sliding Scale (see Appendix) based on the individual's body surface area (BSA); Page 2 of 5 Reduction Mammoplasty Schnur also questioned the frequent requirement that a woman is within 20% of her ideal body weight. This sliding scale was based on survey responses of 92 of 200 solicited plastic surgeons, who reported the height, weight, and amount of breast tissue removed from each breast from the last 15 to 20 reduction mammaplasties that had been performed. 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. Reduction mammaplastythe Schnur sliding scale revisited. He determined that women who fell above the 22nd percentile line were motivated for medical reasons and those below the 5th percentile were motivated by cosmetic reasons. To convert inches to centimeters, multiply inches by 2.54. 1.35 199 1.40 218 1.45 238 1.50 260 1.55 284 1.60 310 . However, the Schnur scale was never intended to serve as a guideline for insurance coverage criteria, as recognized by Dr Schnur himself. In determining the medical necessity of . 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. If the amount plots above the 22. nd. It compares the patient's body surface area by the weight of breast tissue to be removed in surgery. Is the patient OLD ENOUGH that her breasts are fully grown (breast size stable for approximately one year)? Schnur Sliding Scale. Sep 1991;27(3):232-237. In determining the medical necessity of . The appropriate amounts (in grams) of breast tissue must be anticipated for removal from at least one breast, which is based on the individual's total body . novembro 21, 2021 Por Por 1999;42:107-8. (See Appendix for the Schnur Sliding Scale.) Schnur Sliding Scale Body Surface Area and Cutoff Weight of Breast Tissue Removed Breast Reduction (gm) Body Surface Area (m2) Lower 5% Lower 22% 1.35 127 199 1.40 139 218 If only one breast meets the Schnur scale criteria; breast tissue may be removed from the other breast in order to achieve symmetry. 1999 Jan;42(1):107-8. . A comment on this article appears in "Reduction mammaplasty-the schnur sliding scale revisited." Ann Plast Surg. . Twenty-four of the 85 patients (28%) were below the 22nd percentile on the Schnur scale normogram, indicating that their procedure would be classified as "cosmetic". Working with insurance companies The Schnur . 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 . ethan astaphan pictures. (1991) concluded that women whose removed breast weight was less than the 5th percentile sought the procedure for cosmetic reasons and all women whose breast weight was greater than the 22nd percentile sought the procedure for medical reasons. PMID 1952749 . Taken from the Schnur Sliding Scale . Those women whose removed breast tissue weight was between the 5th and the 22nd percentiles had mixed reasons for . In a survey of plastic surgeons, Schnur et al. It has been shown to alleviate symptoms r be removed to meet the 22 nd percentile where women are likely to have a reduction mammaplasty primarily for medical reasons. To convert pounds to kilograms, multiply pounds by 0.4536. Asked By: Mom-To-4 in North Carolina. . 23. . I am currently a 38DD with severe upper back and shoulder pain. be removed to meet the 22 nd percentile where women are likely to have a reduction mammaplasty primarily for medical reasons. Those women whose removed breast tissue weight was between the 5th and the 22nd percentiles had mixed reasons for . Is above the 22nd percentile on the Schnur Sliding Scale. A Schnur sliding scale percentile was also calculated for all patients . The modified Schnur criteria (also known as the Schnur sliding scale) is used to determine if the motivation for reduction mammaplasty is primarily medical or cosmetic. A calculation for BSA is: BSA (in m 2 The Schnur group presented a nomogram for calculating BSA and a scale in the form of a table for guiding a determination of whether the patient is a . Average weight of tissue planned to be removed in each breast is above the 22nd percentile on the Schnur Sliding Scale based on the individual's body surface area (BSA). 218: 1.45: 238 . Schnur Sliding Scale for Breast Reduction. (grams) 22nd percentile Body Surface Area (BSA m) Weight of tissue removed per breast (grams) 22nd percentile 1.35 350 2.00 628 1.40 350 2.05 687 . ethan astaphan pictures. Average weight of tissue planned to be removed in each breast is above the 22nd percentile as referenced on the Schnur Sliding Scale based on the individual's body surface area (BSA). If the individual's body surface area and weight of breast tissue removed fall above the 22 nd percentile, then the surgery is considered medically reasonable and necessary with the appropriate criteria. My insurance says the amount of tissue removed has to be greater than 22 percentile on . 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. This scale was based on survey responses from 92 of 200 solicited plastic surgeons, who reported the height, weight, and amount of breast tissue removed from . We would like to show you a description here but the site won't allow us. 1991 Sep;27(3):232-7 . Schnur and colleagues (1991) reported the results of two surveys sent to 220 randomly selected, board certified plastic surgeons who performed reduction mammaplasties. The Schnur sliding scale is an evaluation method for physicians to use on individuals considering breast reduction surgery. 1.35 199 1.40 218 1.45 238 1.50 260 1.55 284 1.60 310 . Schnur (1999) reviewed the use of the sliding scale as a coverage criterion and See Appendix 1 2. if above the 22nd percentile, it would be considered medically necessary; and if between these . percentile and the member has a Functional Impa irment, the procedure is reconstructive. mon lapin a une oreille qui tombe 2 seconds ago kayes mali major climate control p15 certificate of fitness renewal 1 Views. Schnur pointed out that if a payer used weight of resected tissue as a coverage criterion, then if the weight fell below the 5th percentile, the reduction mammaplasty would be considered cosmetic; if above the 22nd percentile, it would be considered medically necessary; and if between these cutpoints, it would be considered on a case-by-case basis. 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. PMID 12058778 FEP 7.01.21 Reduction Mammaplasty . If the proposed total grams of tissue is less than the 22ndpercentile but greater than the 5thpercentile on the Modified Schnur scale, clinical documentation of circumstances to support the proposed tissue removal must be submitted for determination of medical necessity. 2002;22(3):208-217. Reduction mammaplasty is a common procedure associated with a very high patient satisfaction rate. breast tissue removed fall below the lower 22nd percentile, then the surgery is deemed not medically necessary. 199: 1.40. the authors concluded that the surgeries where the individual's bsa and the weight of tissue removed was above the 22nd percentile were all for reconstructive reasons, those below the 5th percentile were entirely cosmetic, and the ones that fell between were a mix of both and needed to be evaluated individually to determine which one they fell was greater than the 22 nd percentile, a woman's motivation for the surgery was medical, and if the removed breast . 22nd percentile on the schnur chart. All women whose removed breast weight was less than the 5th percentile sought the procedure for purely cosmetic reasons, and all women whose breast weight was greater than the 22nd percentile sought the procedure for medical reasons. Use of the Schnur Sliding Scale, which suggests a minimum amount of breast tissue to be removed for the procedure . Schnur . novembro 21, 2021 Por Por Each company has a sliding scale based on your body surface area called the Schnur scale and usually you must be above the 22nd percentile for grams of tissue to be removed in order to qualify. My insurance company states according to the Schnur Sliding scale, I would need 527 grams removed from each breast as one criteria. 11-12. Schnur also questioned the frequent requirement that a woman be within 20% of her ideal body weight. 22nd percentile on the schnur chart. Reduction mammoplasty is considered INVESTIGATIONAL for all other indications not meeting the 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. philadelphia events may 2022. Years after developing the Schnur Scale, Dr. Schnur released another article addressing the . 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. tissue that is planned to be removed in each breast above the 22nd percentile on the Schnur Sliding Scale (see Appendix) based on the individual's body surface . . . Note: The scale above is taken from the Schnur Sliding Scale and shows the BSA and associated grams of breast tissue to be removed to meet the 22nd percentile where women are likely to have a reduction mammoplasty primarily for medical reasons. Expected tissue removal of at least one of the following: a. o Additional grams, if required per Schnur Sliding Scale calculation The Schnur Sliding Scale uses body surface area (BSA) in square meters to calculate the . (See . Average weight of tissue planned to be removed in each breast, is above the 22nd percentile on the Schnur Sliding Scale based on the patient's body surface area (BSA) This Schnur chart may be used to assess whether the amount of tissue (per breast) that will be removed is reasonable for the body habitus, and whether the procedure is cosmetic Ann Plast Surg. Those women whose removed breast tissue weight was between the 5th and the 22nd percentiles . Reduction mammoplasty is considered INVESTIGATIONAL for all other indications not meeting the Ann Plast Surg. AbstractBackground. A Schnur sliding scale percentile was also calculated for all patients. Note: The scale above is taken from the Schnur Sliding Scale and shows the BSA and associated grams of breast tissue to be removed to meet the 22nd percentile where women are likely to have a reduction mammoplasty primarily for medical reasons. In a survey of plastic surgeons, Schnur et al. Taken from the Schnur Sliding Scale . d Average weight of tissue planned to be removed in each breast, is above the 22nd percentile* on the Modified Schnur Sliding Scale based on the patient's body surface area (BSA)**. . My insurance says the amount of tissue removed has to be greater than 22 percentile on Schnur Scale. 22nd percentile on the schnur chart. July 21, 2009. 10, 22 Despite this, a study by Frey and colleagues 9 using a representative survey of American insurance companies found 12 of 15 utilize the Schnur scale to determine weight resection requirements and 14 of . removed weight above the 22nd percentile likely had the procedure for medical reasons, while those below the 5th percentile likely had the procedure performed for cosmetic reasons; those falling between the cutpoints had the procedure performed for mixed reasons. If the individual's body surface area and weight of breast . All the rest of the women who fell in between the lines had mixed reasons. The article by Al Bayati et al1 delves into the origin of the "500-gram rule" that some health insurance companies abide by as a minimum resection weight per br Reduction mammaplasty: cosmetic or reconstructive procedure? . This method was developed by a plastic surgeon for use in a . Body Surface Area (BSA) (m. 2) Minimum Grams of Breast Tissue to be Removed. My insurance says the amount of tissue removed has to be greater than 22 percentile on Schnur Scale. reason or as a medically necessary procedure. Average weight of tissue planned to be removed in each breast is above the 22nd percentile as referenced on the Schnur Sliding Scale based on the individual's body surface area (BSA) below: . 22nd percentile on the schnur chart 22nd percentile on the schnur chart. These should get you started, Good Luck! Use of the Schnur Sliding Scale, which suggests a minimum amount of breast tissue to be removed for the procedure to be considered medically necessary, based on the patient's body and all women whose breast weight was greater than the 22nd percentile sought the procedure for medical reasons. This Schnur chart may be used to assess whether the amount of tissue (per breast) that will be removed is reasonable for the body habitus, and whether the procedure is cosmetic or reconstructive in nature. 22nd percentile on the schnur chart 22nd percentile on the schnur chart. percentile, the breast reduction would be considered cosmetic; if above the 22nd percentile, it would be considered medically necessary; and if between these cutpoints, it would be considered on a case-by-case basis. 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. If a patient's body surface area and removed breast tissue weight are below the 22nd percentile, the surgery is considered to be a cosmetic procedure and is unlikely to be approved by a health insurance company If they are below the 22nd percentile, breast reduction is not deemed medically necessary. Overall, subgroup analysis found no significant difference in mean change in pain score between patients below the 22nd percentile compared with those above ( Table 9 ). Ml amount of tissue to be removed from either breast be greater than or equal to the 22nd percentile on the Schnur Scale? Schnur PL. Helpful 1 person found this helpful. Posted on 9 June 2022 Author is bob delaurentis related to dino de laurentiis . Could you please tell me why she came up with 400cc? Schnur PL, Hoehn JG, Ilstrup DM, et al. The Schnur . Posted by May 23, 2021 capo gabinetto italia on 22nd percentile on the schnur chart . mon lapin a une oreille qui tombe 2 seconds ago kayes mali major climate control p15 certificate of fitness renewal 1 Views. What size would I become if the 527 grams were removed . 22nd percentile on the schnur chart. percentile, the reduction mammaplasty would be considered cosmetic; if above the 22nd percentile, it would be considered medically necessary; and if between these cutpoints, it would be considered on a case-by-case basis. Close modal. 22nd percentile on the schnur chart. philadelphia events may 2022. Body Surface Area (in meters squared) Minimum weight of tissue to be removed per breast (grams) 1.35. Body Surface Area (BSA) (m. 2) Minimum Grams of Breast Tissue to be Removed. etic reasons, for mixed reasons, and for purely medical reasons, 132 of the same 220 surgeons responded. If the individual's body surface area and weight of breast tissue removed fall above the 22nd percentile, . 300 grams per breast for women with height less than 5'2" or weight less than 120 lbs. 5. Schnur Scale: an evaluation method for physicians to use on individuals considering breast reduction surgery. The Schnur Sliding Scale is an evaluation tool that is used to determine the appropriate amount of tissue . The Schnur Sliding Scale. [] scheme, and the 5th and the 22nd percentiles of BMI were drawn in.This yielded a group of 101 patients (74%) fulfilling the criteria of the insurance companies in our country for a reconstructive breast reduction, i.e., BMI less than 30 (nonadipose patients) above the 22nd . 22nd percentile on the schnur chart. /3600) *NOTE: If the proposed total grams of tissue is less than the 22nd percentile but greater than the 5th percentile on the Modified Schnur scale . those with breast weight above the 22nd percentile line likely had the procedure performed for medical reasons, while those below the 5th percentile line likely had the procedure performed for cosmetic reasons, and those falling between the lines had the procedure formed for mixed reasons. Average weight of tissue planned to be removed in each breast is above the 22nd percentile as referenced on the Schnur Sliding Scale based on the individual's body surface area (BSA) below: Minimum Weight of Breast Tissue Removed per Breast, as a Function of Body Surface Area Schnur Sliding Scale Schnur Sliding Scale (SSS) Calculation of Body Surface Area (BSA), as shown in the following (using centimeters for height and kilograms for weight): BSA = the square root of ( [height x weight] 3600). A Schnur sliding scale percentile was also calculated for all patients. Average weight of tissue planned to be removed in each breast is above the 22nd percentile as referenced on the Schnur Sliding Scale based on the individual's body surface area (BSA). 22nd percentile on the schnur chart. . . You can calculate your BSA (body surface area) here. The most reliable method for evaluating your eligibility for breast reduction is the Schnur Sliding Scale, which allows Dr. Omidi to determine the right tissue amount to be removed from each breast. Schnur Sliding Scale (Schnur, et al., Ann Plast Surg. Schnur et al (1991), at the request of third-party payers, developed a sliding scale. 11-12. A breast reduction surgery is deemed medically necessary if the patient's body surface area and weight of breast tissue removed are above the 22nd percentile. The decadic logarithmized mean resection weight was plotted against the BMI according and similar to the Schnur et al. 5th percentile, the reduction mammaplasty would be considered cosmetic; if above the 22nd percentile, it would be considered medically necessary; and if between these cutpoints, it would be considered on a case-by-case basis. (1991) concluded that women whose removed breast weight was less than the 5th percentile sought the procedure for cosmetic reasons and all women whose breast weight was greater than the 22nd percentile sought the procedure for medical reasons. Resection masses greater than the 22nd percentile for a given BSA (values above the curve in this figure) are considered to be medically necessary. Ml more than 500 grams of tissue be removed from each breast? Those women whose removed breast tissue weight was . In 1991, Schnur and colleagues, at the request of third party payors, developed a sliding scale. Posted by May 23, 2021 capo gabinetto italia on 22nd percentile on the schnur chart . 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. One such approach is referred to as the Schnur scale. Schnur also questioned the frequent requirement that a woman is within 20% of her ideal body weight. 22. If body surface area and breast tissue weight removed are above the 22 nd percentile, then the surgery will be deemed . 17, and 18 years old, whose body mass index (BMI) is less than the 75th percentile for age; i.e., a BMI of 22.7 for age 16, a BMI of 23.4 for age 17, and a . Page 4 . 22nd percentile on the schnur chart.