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I have heard that as of this year BCBS IL has changed the codes they use for transgender female to male top surgery. In years prior the surgery was coded as bilateral masectomy with free nipple graft, but now it is being coded as a breast reduction and therefore insurance claims are being denied. Is this true, and how can I avoid this happening to me when I get the surgery in the coming months? What specific codes should I be looking for to ensure transgender coverage?
Hello, We process claims as they are submitted by the provider, so you will want to speak with your provider to verify the codes that they will be billing to us. Once you have that information, you can send us a private message and we can check on that coverage for you. ~ Heather