Prior Auth Required

21151 - Reconstruction midface, LeFort II; any direction, requiring bone grafts (includes obtaining autografts)

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceReconstruction midface, LeFort II; any direction, requiring bone grafts (includes obtaining autografts)
Procedure / Service Description

Code NAME/DESCRIPTION COMMENTS - (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 autografts); without LeFort I

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