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21160 - Cosmetic Potential Reconstruction midface, LeFort III (extra and intracranial) with

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Procedure / ServiceCosmetic Potential Reconstruction midface, LeFort III (extra and intracranial) with
Procedure / Service Description

Equipment - (includes obtaining autografts) Cosmetic Potential 21160 Reconstruction midface, LeFort III (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts

Likely documents
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  • Submit clinical notes if requested by the plan
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