Prior Auth Required

21193 - Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; without bone graft

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Procedure / ServiceReconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; without bone graft
Procedure / Service Description

Code NAME/DESCRIPTION COMMENTS - 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 Code NAME/DESCRIPTION COMMENTS 21194 Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; with bone graft (includes obtaining

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  • Submit clinical notes if requested by the plan
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  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.