Prior Auth Required

21150 - Reconstruction midface, LeFort II; anterior intrusion (eg, Treacher-Collins Syndrome)

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Procedure / ServiceReconstruction midface, LeFort II; anterior intrusion (eg, Treacher-Collins Syndrome)
Procedure / Service Description

Code NAME/DESCRIPTION COMMENTS - 21147 Reconstruction midface, LeFort I; 3 or more pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted bilateral alveolar cleft or multiple osteotomies) 21150 Reconstruction midface, LeFort II; anterior intrusion (eg, Treacher-Collins Syndrome) 21151 Reconstruction midface, LeFort II; any direction, requiring bone grafts (includes obtaining autografts) 21154 Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining

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