Prior Auth Required

11960 - Cosmetic or Reconstructive The listed codes require a medical necessity determination for coverage. The

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceCosmetic or Reconstructive The listed codes require a medical necessity determination for coverage. The
Procedure / Service Description

Accessory items related to the use of a cardiac mechanical device also require a - Cosmetic or Reconstructive The listed codes require a medical necessity determination for coverage. The 10040; 11421; 11440; 11441; 11442; 11443; 11444; 11446;11950; 11951; 11952; 11954; 11960; Surgery following codes require prior authorization. 11970; 11971; 15777;15780; 15781; 15782; 15786; 15787; 15788; 15789; 15792; 15793; 15820; 15821; 15822; 15823; 15824; 15825; 15826;15828; 15829; 15830; 15832; 15833; 15834; 15835;

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.