Prior Auth Required

21194 - Cosmetic Potential Mandibular/Maxillary (Orthognathic) Surgery - Reconstruction of

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceCosmetic Potential Mandibular/Maxillary (Orthognathic) Surgery - Reconstruction of
Procedure / Service Description

Mountain Health Co-Op, Services Requiring Prior Authorization 7 - osteotomy; without bone graft Cosmetic Potential 21194 Mandibular/Maxillary (Orthognathic) Surgery - Reconstruction of mandibular rami, horizontal, vertical, C or L osteotomy; with bone

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.