Prior Auth Required

40702 - Plastic repair of cleft lip/nasal deformity; Pre-Service Review Required Medical Necessity Submit cephalometric, panoramic films

This procedure appears on the selected insurer prior authorization source.

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Procedure / ServicePlastic repair of cleft lip/nasal deformity; Pre-Service Review Required Medical Necessity Submit cephalometric, panoramic films
Procedure / Service Description

documentation of medical necessity and - procedure report. 40702 Plastic repair of cleft lip/nasal deformity; Pre-Service Review Required Medical Necessity Submit cephalometric, panoramic films primary bilateral, 1 of 2 stages and photos, age and history of orthodontic treatment. Fax to Dental

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.