Prior Auth Required

14000 - structure for the improvement of the person’s appearance or for psychological or

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / Servicestructure for the improvement of the person’s appearance or for psychological or
Procedure / Service Description

requested on a separate authorization request. ADDITIONAL CRITERIA WILL - Cosmetic or Reconstructive Surgery Surgical or other services for cosmetic purposes performed to repair or reshape a body 11450; 11451; 11462; 11463; 11470; 11471; 11920; 11921; 11922; 11950; 11951; structure for the improvement of the person’s appearance or for psychological or 11952; 11954; 11960; 11970; 14000; 14001; 14020; 14021; 14040; 14041; 14060; emotional reasons, and from which no improvement in physiological function can be 14061; 14301; 14302; 15775; 15776; 15777; 15780; 15781; 15782; 15783; 15786; expected, except as such surgery or services are required to be covered by law. 15787; 15788; 15789; 15792; 15793; 15819; 15820; 15821; 15822; 15823; 15824;

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.