So far I found this...breast reconstruction deformity (N65.0), Hx of bilateral mastectomy (Z90.13), and personal history of malignant neoplasm of breast (Z85.3). I had the bilateral mastectomy and the diep flap reconstruction at the same time...about 10 hours. You will need a microsurgeon for the diep flap. Not all plastic surgeons are micro surgeons. Also, maybe your surgeon does not accept Medicare assignment in which case, I think it would not be covered. Where are you located? I am in NJ and would gladly give you my doctor’s name. He told me that everything would be paid for and it was. I had a bad experience finding a surgeon for the mastectomy. The first one I went to was rude and crude and told me that I was too old for diep flap and that I would have to have implants. She worked with a plastic surgeon and would send me to him. I couldn’t get out of that office fast enough. I found the microsurgeon and he directed me to a surgeon. I actually had 2 microsurgeons. While the breast surgeon was doing the mastectomies, the 2 microsurgeon each worked on a side and harvested the tissue from the abdomen and attached it to the chest. All sorts of stuff needed to be reattached so the moved tissue would have a blood supply. I think if I were you I would try to find a good microsurgeon and then they can direct you to a breast surgeon. Please feel free to communicate with me and let me know how you make out. I don’t think I would confront your surgeon as he must have a reason for what he says. It is possible that he doesn’t have experience with doing diep flap or is not a microsurgeon. I think I would shop around...go for a second opinion. I also think there is a law that if you have breast cancer, surgeries and reconstruction have to be covered by insurance if it part of your plan.