Prior Auth Required

21188 - Reconstruction midface, osteotomies Prior Authorization Required Cosmetic - Reconstructive Pre Operative Evaluation, History and

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceReconstruction midface, osteotomies Prior Authorization Required Cosmetic - Reconstructive Pre Operative Evaluation, History and
Procedure / Service Description

Code Description Plan Review Requirement Reviewed For Records Request - bone grafts (includes obtaining autografts); Review @ 425-918-5956 with LeFort I 21188 Reconstruction midface, osteotomies Prior Authorization Required Cosmetic - Reconstructive Pre Operative Evaluation, History and (other than LeFort type) and bone grafts Physical including functional impairment, (includes obtaining autografts) and Operative report

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.