This patient is a 42 year old female who requested a consult at my facility due to problems with oversized breasts. There is also evidence that BSA becomes less accurate at the extremes of height and weight, and BMI may be a better estimate in such cases. schnur scale calculator Web Click here for link to Body Surface Area Calculator. Removed Definitions, Benefit Considerations, and References sections Archived previous policy version CS012.X . 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. |G5 Schlich E, Schumm M, Schlich M: "3-D-Body-Scan als anthropometrisches Verfahren zur Bestimmung der spezifischen Korperoberflache". 1. 2017. endstream endobj 903 0 obj <. or Step 2 . 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). Body Surface Area - Cornell University The calculator below provides results for some of the most popular formulas. Each surgeon who participated in You can also calculate map scale, distance on map and distance in real life on Map Scale Calculator page. Reference: hb```,+@ ( 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. Those lines (at the 22nd and 5th percentile) are the lines of the Schnurr Scale- or rather the line between medical and mixed (22nd percentile) is the Schnurr Scale number that insurance uses. The Institute of Child Welfare, Monograph Series, No. Scale Calculator - Online Scale Converter hbbd``b`+v HX FM0I~ R$D:+$R2012Lf`/@ !< How Does Volume of Resection Relate to Symptom Relief for Reduction Mammaplasty Patients. Quick Calculation of Breast Resection Mass Using the Schnur Scale 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. The https:// ensures that you are connecting to the Reference: DuBois D, DuBois DF. 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 <> Schnur PL. 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. 7y\&0Ywsbvg-IcScXdP17N#T/KAU^4eO8ZY3+Un};VH[aoON 4. Below are some of the most popular formulas for estimating BSA, and links to references for each for further detail on their derivations. A breast reduction surgery is deemed medically necessary if the patients body surface area and weight of breast tissue removed are above the 22nd percentile. New Plastic Surgery Findings From University Of Pittsburgh Outlined A formula to estimate the approximate surface area if height and weight be known. Age: Gender Body description: Step 3. It even allows you to convert fractions of an inch to the correct scale. It is the product of the weight of the person raised to the power 0.425, height BSA Calculator - Body Surface Area Calculator %PDF-1.6 % Would you like email updates of new search results? You can also use this calculator to determine the scale of a building. Haycock GB, Schwartz GJ, Wisotsky DH "Geometric method for measuring body surface area: A height-weight formula validated in infants, children and adults" J Pediatr 1978, 93:62-66. 24+ schnur scale calculator - ShazeabLyndsey Yan M, Bustos SS, Kuruoglu D, Manrique OJ, Tran NV, Sharaf BA, Harless CA, Martinez-Jorge J, Forte AJ, Nguyen MT. Next Steps Body Surface Area m. 2. endobj retrospectively classifying cases as cosmetic or medically necessary. PDF Breast Reduction Surgery - Commercial Medical Policy - UHCprovider.com kilograms and dividing the value by 3600. You can easily put a scale from point A to point B. . When we divide the cardiac output by the BSA, the cardiac index is obtained. Body Surface Area BSA calculator medication doses - Moose and Doc <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Scale factor of length = 4 feet. `PFLfn0Mf:%fL@g%%`81qcXS7@#i@APU 6& 10. Where: CF = conversion factor, N = new recipe amount (or yield), O = original (or old) recipe yield. <>>> CG-SURG-71 Reduction Mammaplasty - Anthem Quick Calculation of Breast Resection Mass Using the Schnur Scale This patient is a 23 year old female who flew in from out of state to my practice with interest in breast reduction surgery. Metabolic mass can be estimated using fat-free mass, where fat-free mass is all of a person's body mass that does not include fat. Boukovalas S, Padilla PL, Spratt H, Tran JP, Li RT, Boson AL, Howland N, Phillips LG. al. Web 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. Breast Reduction, the Schnur Scale, and Insurance Coverage. Schnur Sliding Scale. Enter the two magnitudes you want to compare - for our example, these are 5.8 and 7.1. This table compares the different formulas: Body is divided in 9% areas. Body Surface Area (BSA), along with the threshold for the average weight of breast tissue removed, is incorporated into the Schnur Sliding Scale chart to indicate the medical necessity of reduction mammoplasty. Grams per Breast of Minimum Breast Tissue to be Removed . Unauthorized use of these marks is strictly prohibited. Do Not Copy, Distribute or otherwise Disseminate without express permission. Updated list of Required Clinical Information to reflect/include: o Diagnosis o History of the medical condition(s) requiring treatment or surgical intervention, including: History of chief complaint and associated symptoms A linear scale shows dimensions in a graphical manner and is intuitive to use. How BSA Different From BMI? x\[oH~ia`` v2I2ELOdrFAYUu5W]{X~:y-U\|oN>.nbvytv"$._QDqee,$_^8@o`~UKLL!z#42 Web This calculator yields the required weight of tissue to remove with just knowledge of the patients height and weight and the use of a straight edge. The medical literature supports an approach based on the measurement of . It determines the dose of chemotherapy for a patient. The sliding scale is a chart that takes into account the patients body surface area and the average weight of breast tissue that would need to be removed. Ann Plast Surg. Wampler AT, Powelson IA, Homa K, Freed GL. 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 Calculation formulae in three stages over all ages. Documentation Requirements . 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). Web 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. : BSA is helpful for calculating the following parameters: We calculate by dividing the cardiac output by BSA. the underlying cause has to be identified. Schnur Sliding Scale | Dr. Robert Cohen The Schnur Scale is a table of volumes of breast tissue that need to be removed based on your body surface area. For the hemodynamic parameters, in case of extreme height and weight, PDF 703 Reduction Mammaplasty - Blue Cross Blue Shield of Massachusetts The Schnur Scale will be utilized to determine if the amount of tissue to be removed (per breast) will provide a reasonable expectation of symptom relief for the member's BSA (Dubois) or if the surgery is cosmetic in nature. 1 0 obj BSA and Dosage Calculator: Height: Weight: Drug dosage/ M 2: Equation Used: Program uses the following equation: (Weight) kg 0.425 x (Height) cm 0.725 x 0.007184 = BSA in M 2. This method was developed by a plastic surgeon for use in a study that was done to determine the number of women who had breast reduction surgery for medical reasons only. Then take the square root of the Enter the number of scale length, the real length will be calculated automatically. 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. raised to the power 0.725 and 0.007184, i.e: It is the product of the weight of the person raised to the power 0.5378, height Body Mass Index (BMI) and Body Surface Area (BSA) - MDCalc Body Mass Index (BMI) and Body Surface Area (BSA) Calculates body mass index and body surface area. well as the intensity of kidney issues. This calculator yields the required weight of tissue to remove with just knowledge of the patient's height and weight and the use of a straight edge. 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 . Despite these limitations, the effects of chemotherapy dosages as determined by BSA measurements still remain more consistent than those determined by body weight alone. Posted on June 29, 2022 by . Accessibility This study was not designed for what insurance companies use . A method of estimating the extent of body surface that has been burned in an adult, dividing the body into sections of 9 per cent or multiples of 9 per cent. iPhone. endobj Schnur Sliding Scale. n8"SkOJ}?lt1H/+(qCi(Yy\ s>#^hRKUy:/Bc(,LYS)22"Jhk;~ bX Our scale calculator allows you, based on the given scale factor, to know the object's true size (if you specify its scale size) or scale size (if you specify its actual size). 5. A set of 25 photographs were studied with this software twice by 2 different surgeons. This can be instrumental in determining if breast reduction is being planned for a purely cosmetic reason or as a medically necessary procedure. HHS Vulnerability Disclosure, Help 936 0 obj <>stream "Simplified calculation of body-surface area". MEDICAL POLICY STATEMENT - CareSource Web The only free BMI BSA and Schnur calculator on the App Store This app was written and developed by a surgeon to provide a quick and easy tool for calculating Body Surface. This feature contains nudity. Dr. Cohens insurance authorization team works to help patients who need medically necessary operations get these approved prior to their surgery. stream Comparative Accuracy of Clinical and Formula-Based Estimation of Resection Weight in Reduction Mammoplasty and Implications for Insurance Preapproval and Payment. Once you've entered the number of inches or centimeters, you can then choose a metric scale and select a unit. Using a scale converter is simple and can be used for any project. 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. Europe PMC is an archive of life sciences journal literature. These tools are especially useful for those who need to present their drawing at a particular scale. 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. There Are A Lot Of Apps For That Plastic Surgery Practice. He uses the Schnur Sliding Scale to help him determine these factors with integrity and proper judgment. National Library of Medicine A scale converter is a tool that lets you convert measurements from one scale to another. renal clearance needs to be divided by the BSA, i.e 1.73 m. Bookshelf When converting from one scale to another, you should multiply the number by the scale factor. There are a number of formulas for calculating the BSA, as already stated. PDF Reduction Mammoplasty - Paramount Health Care height and weight be known. The Schnur scale determines the therapeutic necessity of breast reduction surgery by comparing the weight of the removed tissue to your total body area. Schnur f (genitive Schnur, plural Schnre, diminutive Schnrchen n) cord, string (chiefly colloquial) cable (electronic wire) Usage notes . Jan 1999;42(1):107-108. The BSA is frequently used in determining the dosage of medications with a narrow therapeutic index, such as chemotherapeutic agents. PDF Subject: Breast Reduction Supplement In order to calculate the maintenance doses or to compare the high dose use 2019 Jul;144(1):18e-27e. Multiply each ingredient amount by the CF. BU0 j5 Earthquake Calculator. Strength Comparison 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. This evaluation method was developed by a plastic surgeon who did a study on women who required breast reduction surgery for medical reasons. This app was written and developed by a surgeon to provide a quick and easy tool for calculating Body Surface Area, Body Mass Index, Ideal Body Weight and Breast Schnur Weight. Find the recipe conversion factor (CF). This number is acquired using an equation that takes into account your height and weight. ASPS Recommended Insurance Coverage Criteria for Third Party Payers: Reduction Mammaplasty. %PDF-1.5 % A scale converter will also let you change the scale factor in your drawing. The Lund-and-Browder Chart, Wallace Rule-of-Nines, and the palmar method are different ways to calculate and estimate the total body surface area (TBSA) of a burn. 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. BSA calculator is extremely essential and it is calculated because it holds great importance in the medical field. height raised to the power 0.42246 and 0.0235, i.e: BSA = 0.03330 W(0.6157 - 0.0188 log10(W) H0.3. Multiple BSA formulas & Integrated Dosage Calculator: Body surface area (BSA): measured or calculated surface area of a human body. have to be planned. CF = N / O. 579 0 obj <>/Filter/FlateDecode/ID[<96E40E4449AEE74FBC5CA08453111522>]/Index[544 63]/Info 543 0 R/Length 147/Prev 146318/Root 545 0 R/Size 607/Type/XRef/W[1 3 1]>>stream Learn more about what we cover - including health, dental, and pharmacy. 628 0 obj <> endobj 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". For heart failure, an inotropic agent might also be required. PDF Cigna for Health Care Professionals Schnur Weight is used as a reference by plastic surgeons performing breast reduction surgery . PDF 0017 Breast Reduction Surgery and Gynecomastia Surgery - Aetna Copyright 1993-2021 uK@ / H#$D LL@#g` 60m 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. C*0q&EoGG43.|YGe*48|2 h8RYG)M*W=kZdX.DV'q]``l;E2>3?gY?^kauk .UU,I"GiH K!s9h+j\MRIUU6. Scale Factor Calculator- Find Scale Conversions and the square root of 5 is 2.24 m. We demonstrate and compare performance of this calculation by hand and by nomogram. Gehan EA, George SL, Cancer Chemother Rep 1970, 54:225-235, Boyd, Edith (1935). 3 0 obj So these calculations are necessary to achieve medical necessity for insurance authorization for breast reduction. VS 5&rr20DNK6RMqa[G]I&(dt4v4tp444t`3 government site. We Scale Converter - calculate the real length and scale length What Tools Do You Need to Build Scale Models, Tips for understanding and transforming scales. Reduction mammaplasty-the schnur sliding scale revisited. Another useful tool to find a scale converter is a scale ruler. Federal government websites often end in .gov or .mil. The study by Schnur et al was based on a survey of 92 plastic surgeons who reported on their care for 591 patients. Reduction Mammaplasty for Breast-Related Symptoms - BCBSKS Body Surface Area Calculator - Calculate your BSA Copyright 2021 GlobalRPH - Web Development by, HONcode standard for trust- worthy health, Pediatric Oncology: Diagnosis And Prognosis Communication. PDF Reduction Mammaplasty - BridgeSpan Health They presented a very cogent argument for selecting three groups of patients: those with medical indications for operation, those who merit review, and those whose operation could be considered cosmetic. Unable to load your collection due to an error, Unable to load your delegates due to an error. (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 hbbd``b`S"`1A1DD r 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 An official website of the United States government. Guide to Getting Your Breast Reduction Covered by Insurance 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. Display Chap 4 Sect 5.4 (Change 96, Jan 25, 2022) - Tricare Found it! Schnur Scale 5th percentile : r/Reduction - reddit 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. Schnur PL, Hoehn JG, Ilstrup DM, et al. Clipboard, Search History, and several other advanced features are temporarily unavailable. g=CI^DW :pP:2 o2 BOCO6 CQ ^D@Ki <=-ahVnHQYL_U 9uPb)^gO5`W'`$P For gaining the appreciation of true glomerular filtration rate (GFR), the Mosteller RD. After this, the treatment modalities Quick Calculation of Breast Resection Mass Using the Schnur Scale - LWW Sep 1991;27(3):232-237. raised to the power 0.663 and 0.008883, i.e: Here, the BSA for men and women use alternative equations: What parameters require BSA for calculation? According to two prospective studies, women of varying breast . BCBST BMI BSA Breast Reduction Calc 12+ - App Store 544 0 obj <> endobj endstream endobj startxref BSA. PDF Breast Reduction - Cigna hbbd```b`` +@$7dfo`dMlE "tXMX$1|"yHj"z$X\L 6gtAd*v@-GLA"@AGz9@ U1 tachycardia. 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. PDF Reduction Mammaplasty BACKGROUND - American Society of Plastic Surgeons 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. (C9 $*@|BMte.;7zi@iUK+7PLd(?Wh;H,;&?lf%3s\>UC0 The normal range of the the Schnur Sliding Scale, medical necessity will be . 6. You can also use this calculator to convert from one scale to another. Breast Reduction Clean - Blue Cross NC Pulmonary vascular resistance index(PVRI): It is obtained by dividing the vascular resistance by BSA. (2002) published the results of the Breast Reduction: Assessment of Value and Outcomes (BRAVO) study, a registry of 179 women undergoing .