DIEP Flap is one of the most popular reconstruction approaches for patients after breast cancer surgery. However, access to DIEP Flap reconstruction is actively being threatened for our patients.
CMS is working to phase out individual flap reconstruction procedure codes. This means that surgeons will only be compensated at the TRAM (transverse rectus abdominis myocutaneous) rate when they perform DIEP flap. Simply put, surgeons are not going to be compensated for the microvascular skills & experience required to perform the DIEP flap.
While the DIEP flap is not likely to go away, our patients’ ability to access DIEP flap reconstruction is. That’s why I invited Terri Coutee back to the podcast to talk about the latest updates on this very important matter & most importantly: what we must do about it!
DIEP Flap Reconstruction is so much more than “a boob job & a tummy tuck.”
DIEP refers to the deep inferior epigastric perforator, a blood vessel that supplies the inferior abdominal region. In DIEP flap reconstruction, skin, fat tissue, & the supplying blood vessels are removed from the inferior abdominal region & used to reconstruct breast tissue. The blood vessels are then connected to local blood supply in the chest.
DIEP flap spares the muscles commonly used in TRAM flap (or even the latissimus dorsi used in Lat flap reconstruction), meaning patients do not lose muscular function. Patients can even heal faster from DIEP flap, compared to other flap reconstruction approaches.
DIEP flap also requires more advanced training due to the microvascular components, compared to other flap reconstruction approaches. Hence, why DIEP flap often costs more.
DIEP Flap Reconstruction has many benefits for patients.
First & foremost, breast reconstruction has countless psychological benefits for patients after breast cancer surgery.
In addition to the decreased healing time, DIEP flap provides patients with many aesthetic benefits. Many women may have increased abdominal fat tissue, especially after pregnancy. DIEP flap can improve self-confidence & body issues, especially after breast cancer surgery.
Patients must have ACCESS to their chosen reconstruction approach.
We live in a time where there are more reconstruction approaches than ever. Patients MUST have the choice to determine with their medical team which is the best reconstruction approach for them.
Read what Terri had to say about her own choice to undergo DIEP flap reconstruction:
DIEP flap was the best option for me because I had prior radiation to my left breast. Prior to my breast reconstruction the radiation restricted my range of motion and caused discomfort and pain to my left axillary (arm pit) and breast area. Removing the scarring caused by radiation and replacing the radiated tissue with new, soft, warm tummy tissue from the DIEP flap alleviated the pain and greatly improved my range of motion because of my DIEP flap. If I had chosen implants, I ran the very real possibilities and was at high risk of complications around the implants because of the compromised radiated tissue prior to my DIEP flap. A year after my surgery, there was nothing more gratifying than cuddling my newborn grandson against my soft, warm, breasts.
How YOU Can Help Preserve Patient Access to DIEP Flap:
Attend the CMS public hearing on June 1, 2023 & let your voice be heard. Because if we’re not at the table, then we’re on the menu.
Mark your calendars for June 1, 2023.
On June 1, 2023, CMS is hosting their First Biannual 2023 Healthcare Common Procedure Coding System Public Meeting.
TLDR: you need to be at this hearing. This is where CMS will listen to the public about this & other matters.
Register for the Public Hearing here. We need your voice at this public hearing.
You can attend as a non-speaker, but we really need you as a speaker. CMS needs to hear your thoughts on this.
I’ve registered to be a 5 minute speaker, & your voice is needed too.
Register for the Public Hearing here.
Until next time, this is Elise with TheOncoPT. And remember you are exactly the physical therapist that your patients with cancer need. So let’s get to work.