Prior Auth Required

21143 - Reconstruction midface, LeFort I; 3 or more pieces, segment movement in any direction, without bone graft

This procedure appears on the selected insurer prior authorization source.

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Procedure / ServiceReconstruction midface, LeFort I; 3 or more pieces, segment movement in any direction, without bone graft
Procedure / Service Description

Code NAME/DESCRIPTION COMMENTS - Syndrome), without bone graft 21142 Reconstruction midface, LeFort I; 2 pieces, segment movement in any direction, without bone graft 21143 Reconstruction midface, LeFort I; 3 or more pieces, segment movement in any direction, without bone graft 21145 Reconstruction midface, LeFort I; single piece, segment movement in any direction, requiring bone grafts (includes obtaining autografts)

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.