ASPS Recommended Insurance Coverage Criteria for Third Party Payers: Reduction Mammaplasty. endobj The adjusted R 2 values were 0.43 for the Schnur Scale, 0.66 for the Descamps Scale, 0.70 for the Appel Scale and 0.73 for the Galveston scale. 0 The Schnur Sliding Scale chart is an evaluation method used with individuals who are considering breast reduction. x. London: Oxford University Press. PMID 3657876. According to the National Burn Repository, the mean burn size is 13.4% of the total body surface area 1 . The Mosteller formula is recommended 6.To learn more about the issues and differences in BSA formulas, read the BSA standards report by Thanh Vu B.Sc(pharm). Calculation formulae in three stages over all ages. (C9 $*@|BMte.;7zi@iUK+7PLd(?Wh;H,;&?lf%3s\>UC0 BSA is also used in various other clinical settings, such as determining cardiac index (to relate a person's heart performance to their body size) or most commonly, dosages for chemotherapy (a category of cancer treatment). It is a more accurate estimate of total body fat compared with body weight alone. When converting from one scale to another, you should multiply the number by the scale factor. Schnur PL. The .gov means its official. Essentially how big you are and how big your breasts are in relationship to that size which ultimately will determine how much breast tissue is needed to be removed. In a ]U$bH&& 7y\&0Ywsbvg-IcScXdP17N#T/KAU^4eO8ZY3+Un};VH[aoON The scale converter is an useful tool for model railroaders, because it helps you translate the size of your model to the size of the real world. The person may need a fluid bolus for dehydration and Recent medical literature has shown that use of such a chart to discriminate against overweight women by denying them coverage . doi: 10.1097/PRS.0000000000009536. The site is secure. Accessibility A linear scale shows dimensions in a graphical manner and is intuitive to use. 3. doi: 10.1097/PRS.0000000000005712. Nippon Eiseigaku Zasshi 1968;5:443-50. and transmitted securely. Arch Int Med 1916;17:863-71. All Rights Reserved. The Boyd formula 5. The Schnur Scale is a scale used by insurance companies to determine what is in their eyes considered enough breast tissue to be removed to create a medical necessity for the procedure. Once you have done this, the scale converter will provide you with a conversion table. It takes expertise and experience with breast reduction surgery to know ahead of time the amount of tissue that will need to be taken from each breast. |G5 Appendix A: Schnur Sliding Scale Body Surface Area and Minimum Requirement for Breast Tissue Removal Body Surface Area m2 Grams per Breast of Minimum Breast Tissue to be Removed 1.350 -1.374 199 1.375 -1.399 208 1.400-1.424 218 1.425 -1.449 227 1.450 -1.474 238 1.475 -1.499 249 1.500 -1.524 260 1.525 -1.549 272 0 Calculate body surface area given the height and weight The calculation is from the formula of DuBois and DuBois: BSA = (W 0.425 x H 0.725) x 0.007184 where the weight is in kilograms and the height is in centimeters. z9G[c-S4.A. While dosing for chemotherapy is often determined using a patient's BSA, there exist arguments against the use of BSA to determine medication dosages that have a narrow therapeutic index the comparison of the amount of a substance necessary to produce a therapeutic effect, to the amount that causes toxicity. Documentation Requirements . 920 0 obj <>/Filter/FlateDecode/ID[<86C70454DF7C61449ED8F59B4516D99F>]/Index[902 35]/Info 901 0 R/Length 90/Prev 160377/Root 903 0 R/Size 937/Type/XRef/W[1 2 1]>>stream The result is in squared meters, which easily be converted to square feet, inches or yards as needed. Bethesda, MD 20894, Web Policies comparison between the BSA and normal values for assessment of the presence as 4. A scale converter will also let you change the scale factor in your drawing. Macromastia is distinguished from large, normal breast by the presence of . <>>> BSA is often used in clinical purposes over body weight because it is a more accurate indicator of metabolic mass (the body's need for energy). The most widely used of these is the Du Bois formula, which has been shown to be effective for estimating body fat in both obese and non-obese patients, unlike body mass index. endstream endobj startxref The calculator below computes the total surface area of a human body, referred to as body surface area (BSA). You can easily put a scale from point A to point B. Dr. Cohen uses the Schnur Sliding Scale to help patients determine if their breast reduction is medically necessary and then present the proper information to insurance companies. N Engl J Med 1987; 317:1098. Basically the minimum that's needed to be removed in order for you to become free of your symptoms. Like many healthcare insurers, Blue Cross Blue Shield companies often require beneficiaries to plot on or above the 22nd percentile of the Schnur scale to be eligible. 2. Body Surface Area Calculator for medication doses . Schnur and colleagues 33 reported in a study, based on questionnaire responses from women who had undergone reduction mammoplasty that in properly selected individuals, reduction mammoplasty is safe and effective for relieving and improving symptoms related to macromastia. al. Web Schnur scale below. When we divide the cardiac output by the BSA, the cardiac index is obtained. The main step in scaling an object is to find the scale factor, which is the ratio between the real size and the scaled one. This factor can be a fraction, ratio, percentage, or decimal. retrospectively classifying cases as cosmetic or medically necessary. This number is acquired using an equation that takes into account your height and weight. Copyright 2022 - Face+Body. (1991) at the request of third-party payers, developed a sliding scale.10, 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 each a breast from the last 15 to 20 reduction . Example # 03: What is the change in the scale factor when a certain length of 20 inches is scale on a scale of 1 to 10? FOIA 2017. DuBois D, DuBois DF. 10. 5. endobj 4 0 obj Expand PDF Body Surface Area m. How to Use a Scale Converter in a Map Scale Calculator A scale converter is a tool that lets you convert measurements from one scale to another. Schlich formula: Women BSA = 0.000975482 W 0.46 H 1.08 Men BSA = 0.000579479 W 0.38 H 1.24 Schlich E, Schumm M, Schlich M: "3-D-Body-Scan als anthropometrisches Verfahren zur Bestimmung der spezifischen Korperoberflache". Europe PMC is an archive of life sciences journal literature. You can also use this calculator to determine the scale of a building. Despite these limitations, the effects of chemotherapy dosages as determined by BSA measurements still remain more consistent than those determined by body weight alone. The amplitude of shaking is 10 times larger. Breast Reduction Calculator (Schnur Scale ) Breast Reduction Calculator (Schnur Scale ) Nick Masri, MD, FACS The Schnur Scale is a scale used by insurance companies to determine what is in their eyes considered enough breast tissue to be removed to create a medical necessity for the procedure. How Does Volume of Resection Relate to Symptom Relief for Reduction Mammaplasty Patients. Schnur scale below: BSA -1.50 Grams of tissue to be removed per breast 218-260 1.51-1.60 Grams of tissue to be removed per breast 261-310 1.61-1.70 Grams of tissue to be removed per breast -370 1.71-1.80 Grams of tissue to be removed per breast 371-441 -1.90 Grams of tissue to be removed per breast 442-527 Insurance companies have slight variations to this scale, but they are all similar. Web The Schnur Sliding Scale is an evaluation tool that may be used to determine the appropriate amount of tissue to be removed compared to a patients total body surface. According to two prospective studies, women of varying breast . This patient is a 42 year old female who requested a consult at my facility due to problems with oversized breasts. n8"SkOJ}?lt1H/+(qCi(Yy\ s>#^hRKUy:/Bc(,LYS)22"Jhk;~ bX Mosteller RD. Ernahrungs Umschau 2010;57:178-183. This indicates an effective cardiac output. So how much breast tissue that needs to be removed before neck pain, back pain, shoulder pain, skin irritation could potentially be relieved. A new multiplatform software was developed by us and named Breast Aesthetic Scale Calculator (BAS-Calc), which can be executed on Windows Mac, and Linux. resulting value to get the BSA as stated below: A simpler version of this formula is stated below: Let us consider an example to be more clear: Suppose the weight of a random person is 95.45 kg and his height is 190.5 cm, Body Surface Area (m. 2) and Minimum Requirement for Breast Tissue Removal . Schnur Weight is used as a reference by plastic surgeons performing breast reduction surgery . Adults Burn percentage in children and Infants For children and infants, the Lund-Browder chart is used to assess the burned body surface area. Then take the square root of the sharing sensitive information, make sure youre on a federal A modified version of the BSA is the Quetelet index. This site needs JavaScript to work properly. Jul. Multiply each ingredient amount by the CF. PMID 2520314. Enter the scale factor; for example, if you wish to work with a 1/6th scale, input 6. The information, tools, and resources you need to support the day-to-day needs of your office calculator, OR Use the equation: [The square root of: (height in inches) x (weight in pounds)] = BSA m2 o UM Clinicians can approve up to a 100 gram variance (less than required by Schnur Scale) per breast Claim submission requirements Medical necessity is based on the documented symptoms and the requisite grams of tissue to be removed as . (2002) published the results of the Breast Reduction: Assessment of Value and Outcomes (BRAVO) study, a registry of 179 women undergoing . After this, the treatment modalities % BREAST REDUCTION FOR BREAST. You may also be interested in our Cooking Measurement Conversion Calculator or Cake Pan Conversion Calculator It is also convenient for reprinting maps since you will not have to do calculations. O@ raised to the power 0.3964 and 0.024265, i.e: It is the product of the weight of the person raised to the power 0.51456, We demonstrate and compare. tachycardia. In 1991, Dr Paul Schnur and his colleagues published an article correlating the weight of breast tissue to be removed in a breast reduction operation with the total body surface area (BSA) of the patient. 628 0 obj <> endobj It even allows you to convert fractions of an inch to the correct scale. This tool will help you with converting between metric and imperial measurements. University of Minnesota. 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 reconstructive patient as opposed to an aesthetic patient. This patient was suffering from the usual complex of symptoms including back, neck, and shoulder pain, bra strap grooving, and difficulty with exercise due to her heavy breasts. Grams per Breast of Minimum Breast Tissue to be Removed . Kerrigan et al. It's an equation that is derived from determining your body mass. 2019 Jul;144(1):18e-27e. Breast Reduction Calculator - Schnur Scale (Question Answered) Watch on It's an equation that is derived from determining your body mass. %%EOF Web Since the Schnur sliding scale and Seitchik formula lack scientific rigor and validity they should not be used as criteria for approval of insurance coverage. official website and that any information you provide is encrypted <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> There are a number of formulas for calculating the BSA, as already stated. About Calculate Scale calculator. cvkkZpQO/93lnJR\G1V&nZPa??5w)z!vX+/!%]_GM||j\G Gz:.Z]$~p: Ua=#3RxN[;&u+T>P']!a _^=OR$Wh\\;A| doi: 10.1097/SAP.0000000000001885. If they are below the 22nd percentile, breast reduction is not deemed medically necessary. You can input one inch to one mile and vice versa. The Schnur Scale is a table of volumes of breast tissue that need to be removed based on your body surface area. 1 0 obj Reduction mammaplasty: cosmetic or reconstructive procedure? Another useful tool to find a scale converter is a scale ruler. Schnur et al (1991) reported on a sliding scale assigns a weight of breast tissue to be removed based on body weight and surface area. Schnur Sliding Scale: Body Surface Area m 2 Grams per Breast of Minimum Breast Tissue to be Removed 1.350-1.374 199 1.375-1.399 208 1.400-1.424 218 1.425-1.449 227 1.450-1.474 238 1.475-1.499 249 1.500-1.524 260 1.525-1.549 272 1.550-1.574 284 1.575-1.599 297 1.600-1.624 310 1.625-1.649 324 1.650-1.674 338 1.675-1.699 354 1.700-1.724 370 1.725 . The Schnur scale is a poor predictor of breast resection weight, and the Appel scale is the most accurate estimator, especially in the young and obese population with larger resections. Direct measurement of BSA is difficult, and as such many formulas have been published that estimate BSA. He uses the Schnur Sliding Scale to help him determine these factors with integrity and proper judgment. 2022 Oct 1;150(4):723e-730e. government site. There is ample evidence that the practice of applying the Schnur Sliding Scale may be prohibitive to symptomatic patients seeking reduction mammaplasty and should be abandoned. then multiplying these values and diving the resulting value with 3600, we get 5 Schnur Sliding Scale. A formula to estimate the approximate surface area if height and weight be known. 4. height and weight be known. Find the recipe conversion factor (CF). NOTE: When BSA is < 1.350 minimum is 199 grams. For example, 10 cm on a map corresponds to four meters in reality. PMID 9972729 FEP 7.01.21 Reduction Mammaplasty So these calculations are necessary to achieve medical necessity for insurance authorization for breast reduction. Copyright 2021 GlobalRPH - Web Development by, HONcode standard for trust- worthy health, Pediatric Oncology: Diagnosis And Prognosis Communication. Using a scale converter is simple and can be used for any project. If the therapeutic index is too narrow, BSA may not be an accurate enough measure, and there is a risk of causing a toxic rather than therapeutic effect. An evaluation method for physicians to use on individuals considering breast reduction surgery.
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