Schnur Scales

What is a Schnur Scale?

, often called the Schnur Sliding Scale, is an assessment tool widely utilized by plastic surgeons and insurance companies to ascertain the medical necessity of breast reduction surgeries. This scale was conceptualized following a comprehensive study highlighting significant improvements in posture, neck discomfort, and back pain following breast reduction procedures.

The Schnur Scale employs a patient's Body Surface Area (BSA) and the volume of breast tissue proposed for removal to arrive at its determination. This tool is pivotal in the preauthorization process for breast reduction surgeries, particularly in the western United States, where it is widely accepted and used.

How does it work?

The functionality of the Schnur Scale is rooted in its systematic approach to determining the medical necessity for breast reduction surgeries. The process involves four key steps:

Step 1: Calculating the Patient's Body Surface Area (BSA)

The first step measures the human body's total surface area and is generally calculated using the patient's height and weight. The BSA provides a more accurate representation of metabolic mass than body weight alone, making it an essential factor in medical assessments.

Step 2: Determining the Volume of Tissue Removal

Next, the surgeon needs to determine the quantity of breast tissue that should be removed to achieve the desired outcome and alleviate any physical discomfort experienced by the patient. This decision is based on various factors, including the patient's overall health, body proportions, and personal preferences.

Step 3: Consulting the Schnur Scale

Once the BSA and proposed tissue removal volume have been established, the surgeon refers to the Schnur Scale. This tool offers a range of tissue weights for each BSA category that should be removed to consider the operation medically necessary. It serves as an objective guideline to assist surgeons in making informed decisions about the medical necessity of breast reduction surgeries.

Step 4: Submitting for Preauthorization

If the proposed volume of tissue to be removed aligns with the recommendations of the Schnur Scale, the surgeon can proceed to submit a preauthorization request to the insurance company. This step is crucial to ensure the patient's insurance plan covers the procedure.

We have a printable version of the Schnur Scale for reference to facilitate this process. This resource allows patients and healthcare providers to access the information and guidelines the scale provides readily. By understanding and correctly implementing the Schnur Scale, surgeons can make evidence-based decisions regarding breast reduction surgeries, ultimately leading to improved patient outcomes.

When would you use this Form?

The Schnur Scale finds its primary application in plastic surgery, particularly when considering the medical necessity of breast reduction surgeries. The scale is a crucial tool for surgeons and insurance companies, helping them make evidence-based decisions regarding the procedure.

• Breast reduction surgery, while often perceived solely as a cosmetic procedure, can have significant health implications for patients suffering from physical discomfort due to large breasts. These discomforts may manifest as chronic neck pain, persistent back pain, poor posture, or skin issues under the breast area. In such cases, breast reduction surgery can significantly improve the patient's quality of life.
• The Schnur Scale comes into play during the preoperative planning phase. Surgeons use this scale to quantify the volume of breast tissue that needs to be removed to alleviate the patient's symptoms. The scale considers the patient's Body Surface Area (BSA). It correlates it with the amount of tissue proposed to be removed. This systematic approach provides an objective measure of the surgery's medical necessity.
• Insurance companies use the Schnur Scale as a standard to preauthorize breast reduction surgeries. Suppose the proposed volume of tissue to be removed aligns with the recommendations of the Schnur Scale. In that case, the procedure is more likely to be deemed medically necessary and thus covered by the patient's insurance plan.

The Schnur Scale is an invaluable resource when contemplating breast reduction surgery, serving as a guide for surgeons and insurance providers. By using this scale, healthcare professionals can ensure they make decisions rooted in empirical evidence, ultimately leading to better patient outcomes and improved healthcare delivery.

Benefits

Using the Schnur Scale offers several benefits:

Objective Evaluation

Our free Schnur Scale provides an objective measure to determine the medical necessity of breast reduction surgery.

Insurance Preauthorization

It aids in securing insurance preauthorization for the procedure and ensuring financial coverage for the patient.

Patient Consultation

This free Schnur Scale is functional during patient consultation, helping patients understand the surgical process and expected outcomes.

Evidence-Based Practice

The Schnur Scale is backed by research, making it an evidence-based practice in plastic surgery.

Research & Evidence

The inception of the Schnur Scale is rooted in a comprehensive study conducted by a team of plastic surgeons. They sought to demonstrate the medical advantages associated with breast reduction surgery objectively. Their research led to the development of this scale, which has since become an invaluable tool in plastic surgery.

The Schnur Scale was not born overnight. It's the product of painstaking research and rigorous scientific analysis. The goal was to create a standardized method to accurately determine the medical necessity of breast reduction surgeries. This was a critical need in the industry, as these procedures were often erroneously viewed as purely cosmetic, neglecting the significant health implications for patients suffering from physical discomfort due to large breasts.

Since its introduction, plastic surgeons and insurance companies have widely recognized and utilized the Schnur Scale. The scale provides an empirical basis for determining whether breast reduction surgery is medically necessary. Considering the patient's Body Surface Area (BSA) and the volume of breast tissue proposed to be removed, the scale offers a systematic approach to making this determination.

The use of the Schnur Scale is substantiated by a body of research that affirms its effectiveness. Studies have shown that the scale accurately predicts the relief of symptoms following breast reduction surgery. As such, it is crucial in improving patient outcomes and quality of life.

The Schnur Scale is a testament to the power of research and evidence-based medicine. Its widespread acceptance underscores the importance of scientific research in advancing medical practices and ensuring the delivery of high-quality healthcare.

References

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6157938/
• https://ps-rc.org/meeting/abstracts/2020/eP170.cgi