Is Bilateral Mastectomy REALLY an Outpatient Procedure?

BunnyJane
BunnyJane Member Posts: 213
edited March 2014 in Breast Cancer #1
I'm scheduled for a bilateral mastectomy next Tuesday and just found out that my insurance considers this operation to be an outpatient procedure. Has anyone else had a bilateral done as an outpatient procedure? I am not having reconstruction. Thx! Jane
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Comments

  • ladybug22
    ladybug22 Member Posts: 646
    mine was
    they let me stay 23 hours. I did not have reconstruction . good luck and hugs to you
  • tigger99
    tigger99 Member Posts: 44
    For my insurance (and many
    For my insurance (and many others), an "outpatient procedure" is one where the hospital stay is what they call a 24 hour hold, but 24 hours can be longer than that. For example, my surgery was at 11 a.m. on Monday. I left the hospital at 9 p.m. Tuesday and it was still considered the 24 hour rule because (as far as my insurance was concerned) the 24 hours went until midnight Tuesday.
  • BunnyJane
    BunnyJane Member Posts: 213
    tigger99 said:

    For my insurance (and many
    For my insurance (and many others), an "outpatient procedure" is one where the hospital stay is what they call a 24 hour hold, but 24 hours can be longer than that. For example, my surgery was at 11 a.m. on Monday. I left the hospital at 9 p.m. Tuesday and it was still considered the 24 hour rule because (as far as my insurance was concerned) the 24 hours went until midnight Tuesday.

    outpatient
    My surgery is scheduled for the afternoon and I am to be discharged the same day.
  • cindycflynn
    cindycflynn Member Posts: 1,132 Member
    I had a lumpectomy
    and it was outpatient, but my surgeon had told me ahead of time that if they found cancer in my sentinal lymph node that they would keep me overnight because they would need to remove more (mine were clear so I didn't have to stay).

    I would suggest talking about this with your surgeon. Even if the "standard care" is outpatient, that doesn't mean the insurance won't cover a longer stay if your doctor feels it's medically necessary. Your surgeon might give you some insight as to how he/she normally handles this with the insurance company.

    Good luck on your surgery.

    Take care,
    Cindy
  • seof
    seof Member Posts: 819 Member
    Talk to your Dr.
    I had expanders in at the same time as the mastectomy. I went in the hospital on Dec. 21 and got home Dec. 24. Talk to your Doctor and ask the insurance company about whether they would cover a longer stay if the Dr. feels it is medically necessary. If you have good help at home, are not getting expanders, and have no complications, I think you would probably be OK, but the Dr. may need to contact the insurance co. about it. I would say the Dr. is the first person to talk to about it.

    Best wishes in getting it all settled. seof
  • mimivac
    mimivac Member Posts: 2,143
    Hospital stays
    Jane, I cannot imagine that insurance would refuse to pay for a hospital stay if one should become necessary. They just want to make sure the presumption is for "outpatient." But what are they going to do, kick you out on the street? Don't worry, they won't let you leave if they think you need to stay. I wish you luck.

    Mimi
  • New Flower
    New Flower Member Posts: 4,294
    mimivac said:

    Hospital stays
    Jane, I cannot imagine that insurance would refuse to pay for a hospital stay if one should become necessary. They just want to make sure the presumption is for "outpatient." But what are they going to do, kick you out on the street? Don't worry, they won't let you leave if they think you need to stay. I wish you luck.

    Mimi

    at least next day
    I as understand in my breast center after mastectomy they keep patients overnight and discharged next day. Talk to your doctor insurance should follow doctor's recommendations.
  • BunnyJane
    BunnyJane Member Posts: 213

    at least next day
    I as understand in my breast center after mastectomy they keep patients overnight and discharged next day. Talk to your doctor insurance should follow doctor's recommendations.

    Kicking and screaming
    Thanks for all of your responses.

    I spent most of the day discussing this matter with the insurer and they have approved me for a stay of up to two days. It isn't quite a vacation with room service and drinks with little umbrellas, but sounds like I will at least get to stay overnight after the surgery.
  • New Flower
    New Flower Member Posts: 4,294
    BunnyJane said:

    Kicking and screaming
    Thanks for all of your responses.

    I spent most of the day discussing this matter with the insurer and they have approved me for a stay of up to two days. It isn't quite a vacation with room service and drinks with little umbrellas, but sounds like I will at least get to stay overnight after the surgery.

    Good news
    Yes, we have to fight insurance as well.
    Well done,
    Good luck with you surgery
  • Eil4186
    Eil4186 Member Posts: 949
    I had a lumpectomy and a
    I had a lumpectomy and a sentinal node biopsy and I stayed in the hospital overnight. My surgeon told me prior to the procedure that it was up to me; if I felt that I would like to stay, then I could. It was comforting to stay, but looking back on it now, I should have gone home because it was a simple surgery and I was unable to sleep due to noise.

    In my opinion a bilateral mast. should warrant a couple of days. That is a substantial surgery. I can't imagine having this surgery and then being shuffled home. Talk to your surgeon.
  • e_hope
    e_hope Member Posts: 370
    I got to stay a whole 23
    I got to stay a whole 23 hours ( had double mastectomy with reconstruction and lymph node removal)... insurance companies are out of their minds... the fist 18 hours had the worst pain EVER....

    what is sad you have a baby and you get to stay 2 days.. and c-section 4 days... have your whole chest cut off.. and kicked out less than 24 hours later...
  • mlmjt1
    mlmjt1 Member Posts: 537
    Hi Jane
    I had bilateral mastectomy with expanders placed. I was out in less than 24 hours. Pretty much when I woke up I could go.

    Hang in there...you recover better at home anyway
    Hugs
    lindat
  • lynn1950
    lynn1950 Member Posts: 2,570
    I was glad to read that your
    I was glad to read that your insurance will let you stay longer. I had a bilateral mastectomy and was in the hospital for 2.5 days and I really needed the care. Maybe my stay was longer because I developed a hematoma. Stay and rest as long as you can! xoxoxoxo Lynn
  • Wolfi
    Wolfi Member Posts: 425
    BunnyJane said:

    outpatient
    My surgery is scheduled for the afternoon and I am to be discharged the same day.

    That doesn't sound right to me
    Surgery in the afternoon and discharged the same day doesn't seem like enough recovery time. I had my surgery in the morning and left the hospital late the following morning.
  • TriciaMc
    TriciaMc Member Posts: 2
    BunnyJane said:

    Kicking and screaming
    Thanks for all of your responses.

    I spent most of the day discussing this matter with the insurer and they have approved me for a stay of up to two days. It isn't quite a vacation with room service and drinks with little umbrellas, but sounds like I will at least get to stay overnight after the surgery.

    Bilateral
    Hi Jane - I had a bilateral with delayed reconstruction on November 5 - 9am surgery and home by 3:30pm! I felt more comfortable at home after the surgery than staying in the hospital, which would have been an option if needed (complications). Be sure to discuss your concerns with your surgeon/team and make sure they understand where you stand on this. I wish a speedy recovery!
    Tricia
  • lovelylola
    lovelylola Member Posts: 279
    Yep,
    23 hours for a bilateral mastectomy with no reconstruction. In surgery by 12:00 noon on a Thursday and discharged from the hospital by 11:00 am on Friday. I was surprised too but had no complications and in my case actually felt pretty good except for some residual tenderness. Didn't even need to take any pain meds past Friday afternoon.
  • tommaseena
    tommaseena Member Posts: 1,769

    Yep,
    23 hours for a bilateral mastectomy with no reconstruction. In surgery by 12:00 noon on a Thursday and discharged from the hospital by 11:00 am on Friday. I was surprised too but had no complications and in my case actually felt pretty good except for some residual tenderness. Didn't even need to take any pain meds past Friday afternoon.

    Not for me
    I had surgery on 2/2/09 and was not discharge until 2/4/2009. I had bilateral mastectomies with tissue expanders put in at the time with sentinel node removed.

    I think it depends not only on the doctor/surgeon but your insurance company as well. My insurance policy reads two day stay or longer if complications.

    I'm hoping the best for you.

    Hugs,
    Margo
  • mberg
    mberg Member Posts: 62
    I had my surgery this past
    I had my surgery this past fri morning and left the hospital sunday afternoon because i was still in pain. The dr CAN admit you if you are having any issues w/ pain,nausea,etc. Don't let them fool you, my dr said he would keep me all week if i needed him to. It's dr discretion if you are admitted after the 23 hr hold.good luck!!monica
  • KBushart
    KBushart Member Posts: 7
    mlmjt1 said:

    Hi Jane
    I had bilateral mastectomy with expanders placed. I was out in less than 24 hours. Pretty much when I woke up I could go.

    Hang in there...you recover better at home anyway
    Hugs
    lindat

    That sounds like my experience
    Would you mind if I ask how you did with pain etc. after that? I had my surgery 11/11 and the drains removed 12 days later. I'm still in quite a bit of pain and wondering if this is normal. Seems like I should be feeling better than I am.

    Thanks,
    Kim
  • kimber10
    kimber10 Member Posts: 47
    I had 2 lumpectomys (1 on
    I had 2 lumpectomys (1 on each breast) in May went into surgery at 9 am was home by 5 that evening that wasn't to bad I was glad to be home, then in July I had a bilateral mastectomy and my dr said I could go home that same day but it was my choice and I chose to stay because of the pain and I was very nauseated.
    Kim