Prior Auth Required
21154 - Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining
This procedure appears on the selected insurer prior authorization source.
Prior authorizationPrior Auth Required
Procedure / ServiceReconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining
Procedure / Service Description
Code NAME/DESCRIPTION COMMENTS - 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 21155 Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining
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.