Prior Auth Required

21172 - Reconstruction superior-lateral orbital rim and lower forehead, advancement or alteration, with or without

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Procedure / ServiceReconstruction superior-lateral orbital rim and lower forehead, advancement or alteration, with or without
Procedure / Service Description

Code NAME/DESCRIPTION COMMENTS - 21160 Reconstruction midface, LeFort III (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); with LeFort I 21172 Reconstruction superior-lateral orbital rim and lower forehead, advancement or alteration, with or without grafts (includes obtaining autografts) 21175 Reconstruction, bifrontal, superior-lateral orbital rims and lower forehead, advancement or alteration (eg,

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