Prior Auth Required

21256 - Cosmetic Potential Reconstruction of orbit with osteotomies (extracranial) and with

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceCosmetic Potential Reconstruction of orbit with osteotomies (extracranial) and with
Procedure / Service Description

Mountain Health Co-Op, Services Requiring Prior Authorization 8 - with bone and cartilage (includes obtaining autografts) Cosmetic Potential 21256 Reconstruction of orbit with osteotomies (extracranial) and with bone grafts (includes obtaining autografts) (eg, micro-ophthalmia)

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.