Q83.0 Insurance Policy Changes

ICD-10 Q83.0 is officially defined as "Congenital absence of breast with absent nipple." code Q83.0 is referenced in 5 tracked payer policy changes from Blue Cross & Blue Shield of Mississippi and Independence Blue Cross. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code Q83.0 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Augmentation Mammoplasty
This Blue Cross Blue Shield policy states that benefits are specifically excluded when augmentation mammoplasty is performed for cosmetic purposes. Augmentation may be considered reconstructive in listed situations, including agenesis or severe hypoplasia with a 50% or greater deformity of the contralateral breast, scoliosis, Poland's syndrome, chest wall deformity such as pectus excavatum, breasts damaged by infection, traumatic loss, scarring, burns or X-ray therapy, and reconstruction after mastectomy for cancer. The 03/27/2026 policy update removed the ICD-9 procedure and diagnosis codes.
Independence Blue Cross · Identified Jun 19, 2026Low impact
MA11.072, Application and Removal of Tattoos
Independence Blue Cross reissued MA11.072 on 03/04/2026 to reaffirm its continuing position on tattoo application and removal coverage for Medicare Advantage members. The policy covers therapeutic tattoos (corneal leukoma concealment, radiation therapy marking, nipple/areola reconstruction), traumatic tattoo removal, and removal of tattoos with medical complications, while excluding cosmetic tattoos. No substantive coverage changes were made; this is a routine policy reissuance.
Independence Blue Cross · Identified Jun 19, 2026Low impact
MA11.072, Application and Removal of Tattoos
Independence Blue Cross reissued MA11.072 on 03/04/2026 to communicate the Company's continuing position on tattoo application and removal. No substantive changes to coverage criteria were made; this is a routine reissue. The policy clarifies that therapeutic tattoos (corneal leukoma concealment, radiation therapy marking, nipple/areola reconstruction) and medically necessary removal (traumatic tattoos, complications) are covered, while cosmetic tattooing is not covered under Medicare Advantage.
Independence Blue Cross · Identified Jun 19, 2026Low impact
11.08.05g, Application and Removal of Tattoos
This is a reissue of Independence Blue Cross policy 11.08.05g on tattoo application and removal with no substantive changes to coverage criteria. The policy continues to cover medically necessary therapeutic tattoos (corneal leukoma concealment, radiation therapy marking, breast reconstruction), traumatic tattoo removal, and removal due to medical complications, while excluding cosmetic tattoos. Billing teams should verify this reissue does not affect current claim processing, as coverage determinations remain unchanged from prior versions.
Independence Blue Cross · Identified Jun 19, 2026Low impact
11.08.05g, Application and Removal of Tattoos
Independence Blue Cross has reissued Policy 11.08.05g confirming its continuing position on tattoo application and removal. No substantive coverage changes were made; the policy maintains coverage for medically necessary therapeutic tattoos (corneal leukoma concealment, radiation therapy marking, breast reconstruction), traumatic tattoo removal, and removal due to medical complications, while excluding cosmetic tattoos. This is a routine reissue for policy maintenance purposes.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code Q83.0?

There are 5 tracked policy changes affecting code Q83.0, including updates from Blue Cross & Blue Shield of Mississippi, Independence Blue Cross. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code Q83.0?

Payers that have issued tracked updates for code Q83.0 include: Blue Cross & Blue Shield of Mississippi, Independence Blue Cross.

How do I get notified when code Q83.0 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code Q83.0. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for code Q83.0?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

All billing codes J3590 C9399 J3490 99215 99213 99202

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Augmentation Mammoplasty

MA11.072, Application and Removal of Tattoos