The Women's Health and Cancer Rights Act of 1998 (WHCRA), often referred to as Janet's Law, is a federal law that provides protections to patients who choose to have breast reconstruction in connection with a mastectomy. Administered by the Departments of Labor and Health and Human Services, it is one of the most important pieces of legislation for breast cancer survivors.

What many women do not realize until the very end of their journey is that WHCRA requires group health plans and insurers that cover mastectomy to also cover all stages of breast reconstruction. This explicitly includes surgery and reconstruction of the other breast to produce a symmetrical appearance, and crucially, prostheses and treatment of physical complications at all stages of the mastectomy, which includes areola restoration.

In medical terms, areola micropigmentation is often billed under CPT codes 11920-11922, paired with an ICD-10 diagnosis code for acquired absence of the breast and nipple (such as Z90.11 for the right breast, Z90.12 for the left, or Z90.13 for bilateral). While the law is clear, the process of reimbursement often falls on the patient because many independent medical-tattoo artists, including myself, operate out-of-network.

The out-of-network process generally means you will pay for your procedure at the time of service and then submit a claim to your insurance company for reimbursement. To make this process as smooth as possible, our studio provides every restorative client with a complete insurance documentation package. This includes a Letter of Medical Necessity and an itemized superbill detailing the exact CPT and ICD-10 codes insurers look for.

A note in honesty: while WHCRA applies to most group and individual health plans, it does not apply to Medicare or Medicaid, and some church or government plans may be exempt. Furthermore, reimbursement is determined by your individual plan and is never guaranteed. We always recommend confirming coverage and any pre-authorization requirements with your insurer before your appointment.

Areola restoration is the final step in a long, arduous journey. It is the moment you look in the mirror and recognize yourself again. I am here to guide every client through this process with patience, warmth, and absolute discretion, ensuring you receive not only the finest artistry, but the support you need to feel whole.