Prior Auth Required

21150 - Lefort II , All

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceLefort II , All
Procedure / Service Description

Service Category Benefit/Description Codes Requiring Authorization Member Program* - Midface Reconstruction (other) 21188 All Lefort I 21141, 21142, 21143, 21145, 21146, 21147 All Lefort II 21150, 21151 All Orthognathic Surgery / Mandible Reconstruction 21193, 21194, 21195, 21196 All With Osteotomy Segmental 21198 All

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.