External Breast Prostheses
National · Effective Apr 1, 2025
1 active Medicare policy lists L8039, and 8 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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National · Effective Apr 1, 2025
8 policies from 7 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of L8039 |
|---|---|---|
| Gender Affirming Interventions for Gender Dysphoria | Apr 1, 2026 | Covered |
| Reconstructive Breast Surgery/Mastopexy, and Management of Breast Implants | Dec 1, 2025 | Covered |
| Policy | Effective | Status of L8039 |
|---|---|---|
| Reconstructive Breast Surgery | May 15, 2026 | Covered |
| Policy | Effective | Status of L8039 |
|---|
| Reconstructive Breast Surgery | May 15, 2026 | Covered |
|---|
| Policy | Effective | Status of L8039 |
|---|---|---|
| Reconstructive Breast Surgery | May 15, 2026 | Covered |
| Policy | Effective | Status of L8039 |
|---|---|---|
| Reconstructive Breast Surgery | May 15, 2026 | Covered |
| Policy | Effective | Status of L8039 |
|---|---|---|
| Breast Reconstruction Following Mastectomy or Lumpectomy | Apr 15, 2026 | Covered |
| Policy | Effective | Status of L8039 |
|---|---|---|
| Cigna Medicare Advantage Durable Medical Equipment Code List - Effective 01/01/2025 | Jan 1, 2025 | Prior auth required |