Prior Auth Required

21188 - Reconstruction midface, osteotomies (other than LeFort type) and bone grafts (includes obtaining autografts)

This procedure appears on the selected insurer prior authorization source.

Prior authorizationPrior Auth Required
Procedure / ServiceReconstruction midface, osteotomies (other than LeFort type) and bone grafts (includes obtaining autografts)
Procedure / Service Description

Code NAME/DESCRIPTION COMMENTS - excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting greater than 80 sq cm 21188 Reconstruction midface, osteotomies (other than LeFort type) and bone grafts (includes obtaining autografts) 21193 Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; without bone graft

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.