Prior Auth Required

21121 - Genioplasty; sliding osteotomy, single Possible Denial; Medical Records Cosmetic MDs fax to IHM at 800-843-1114; DDS or

This procedure appears on the selected insurer prior authorization source.

Check another codeExplore policy data
Prior authorizationPrior Auth Required
Procedure / ServiceGenioplasty; sliding osteotomy, single Possible Denial; Medical Records Cosmetic MDs fax to IHM at 800-843-1114; DDS or
Procedure / Service Description

joint arthrography medical necessity. - orthodontic treatment. Fax to Dental Review @ 425-918-5956 21121 Genioplasty; sliding osteotomy, single Possible Denial; Medical Records Cosmetic MDs fax to IHM at 800-843-1114; DDS or piece Optional DMDs: Complete the Dental Prior Authorization form found at:

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.