Enter the policy number without the version number (last 3 digits). Safety and effectiveness of microvascular decompression for treatment of hemifacial spasm: a systematic review. These surgeries are usually complex and may involve several procedures or stages to accomplish the desired result. B. OtoplastyWhen services may be Medically Necessary or Reconstructive when criteria are met: Otoplasty, protruding ear, with or without size reduction, Unlisted procedure, external ear [when specified as other otoplasty], Prosthetic implant, not otherwise specified [when describing a prefabricated, custom-fitted auricular implant], Reposition external ear [right, left or bilateral, by approach; includes codes 09S00ZZ, 09S04ZZ, 09S0XZZ, 09S10ZZ, 09S14ZZ, 09S1XZZ, 09S20ZZ, 09S24ZZ, 09S2XZZ], Supplement external ear with autologous tissue substitute [right, left or bilateral, by approach; includes codes 09U007Z, 09U0X7Z, 09U107Z, 09U1X7Z, 09U207Z, 09U2X7Z], Supplement external ear with synthetic substitute [right, left or bilateral, by approach; includes codes 09U00JZ, 09U0XJZ, 09U10JZ, 09U1XJZ, 09U20JZ, 09U2XJZ], Supplement external ear with nonautologous tissue substitute [right, left or bilateral, by approach; includes codes 09U00KZ, 09U0XKZ, 09U10KZ, 09U1XKZ, 09U20KZ, 09U2XKZ], Release ear skin, external approach [right or left; includes codes 0HN2XZZ, 0HN3XZZ], Alteration of external ear with autologous tissue substitute [right, left or bilateral, by approach; includes codes 090007Z, 090037Z, 090047Z, 0900X7Z, 090107Z, 090137Z, 090147Z, 0901X7Z, 090207Z, 090237Z, 090247Z, 0902X7Z], Alteration of external ear with synthetic substitute [right, left or bilateral, by approach; includes codes 09000JZ, 09003JZ, 09004JZ, 0900XJZ, 09010JZ, 09013JZ, 09014JZ, 0901XJZ, 09020JZ, 09023JZ, 09024JZ, 0902XJZ], Alteration of external ear with nonautologous tissue substitute [right, left or bilateral, by approach; includes codes 09000KZ, 09003KZ, 09004KZ, 0900XKZ, 09010KZ, 09013KZ, 09014KZ, 0901XKZ, 09020KZ, 09023KZ, 09024KZ, 0902XKZ], Alteration of external ear [right, left or bilateral, by approach; includes codes 09000ZZ, 09003ZZ, 09004ZZ, 0900XZZ, 09010ZZ, 09013ZZ, 09014ZZ, 0901XZZ, 09020ZZ, 09023ZZ, 09024ZZ, 0902XZZ], When services are Cosmetic and Not Medically Necessary:For the procedure codes listed above, when criteria are not met for medically necessary or reconstructive services, or when the code describes a procedure indicated in the Position Statement section as cosmetic and not medically necessary, including the following, Prosthetic implant, not otherwise specified [when describing a custom-fabricated auricular implant]. Revision of Position Statement for reconstructive rhinoplasty for nasal fractures. When a broken nose is straightened back to its normal shape out of medical necessity, it is called an open reduction nasal and septal fracture. Dr. Lam philosophy of striving to give patients a natural, non-surgical look. He is board-certified by the American Board of Otolaryngology Head and Neck Surgery, one of the oldest medical specialties in the country. They are commonly referred to as ENT physicians. No. 2023 health coverage Our flexible plans have you covered. Ann Otol Rhinol Laryngol. (pmo) 7/14/08 Under When Covered section: C.1. Helped me with treatment plans for my condition.". 2014; 46(1):8-12. NCD #140.4. During the four years that he directed the program, several thousand much-needed textbooks were sent to medical institutions in Liberia, Kenya, Uganda, Nigeria and Zimbabwe. Summary of Safety and Effectiveness. "To the point and very professional. Benefit Summary Book. Our Patient Advocate Center hours are are Monday-Thursday 8 a.m.- 7 p.m., Friday 8 a.m.-5 p.m. and Saturday 8 a.m.- 12 p.m.. These ratings are based on verified reviews submitted by real patients. On average, patients who use Zocdoc can search for an Ear, Nose & Throat Doctor who takes Blue Cross Blue Shield insurance, book an appointment, and see the Ear, Nose & Throat Doctor within 24 hours. Added reference for Centers for Medicare and Medicaid Services (CMS) National Coverage Determination (NCD). 2010; 143(1):48-59. Please call by Friday 5pm for Monday cancellations. Available at: U.S. National Library of Medicine Medline Plus. Reordered text and updated Background/Overview. Revision surgery - Revision plastic surgery is generally more expensive than primary surgery
Provided clarification of Position Statement for when otoplasty is considered reconstructive. Yetiser S, Karapinar U. Hypoglossal-facial nerve anastomosis: a meta-analytic study. Dr. Lessow specializes in nasal and sinus disease as well as treating all general ear, nose and throat problems. Eileen Raynor completed their Medical School at University Of North Carolina At Chapel Hill School Of Medicine. That way, youll only see Ear, Nose & Throat Doctors who match your preferences. Medical Policy & Technology Assessment Committee (MPTAC) review. MPTAC review. These reconstructive surgical procedures are also performed to address an individuals significantly altered appearance in the treatment of congenital or acquired facial palsy. 2002; 16(5):243-248. 1 0 obj The members contract benefits in effect on the date that services are rendered must be used. Most insurers provide coverage for video visits at the same cost as in-person visits. Technical advances in the correction of septal perforation associated with closed rhinoplasty. Medical policies are based on proven merits and credible scientific evidence. You will have your temperature taken at the door before you enter. Otoplasty is considered medically necessary when performed to surgically correct a physical structure or absence of a physical structure that is causing hearing loss, or intended to facilitate the use of a hearing aid or device when both of the following criteria are met: Otoplasty is considered reconstructive when intended to restore a significantly abnormal external ear or auditory canal related to accidental injury, disease, trauma, or treatment of a disease or congenital defect. Available at: U.S. Food and Drug Administration (FDA) 510(k) Premarket Notification Database. A neck tuck, also known as a neck lift, lower rhytidectomy or submental lipectomy, is a surgical procedure to remove excess skin and fat from the neck area under the chin. Cosmetic rhinoseptoplasty in acute nasal bone fracture. Rhinoseptoplasty is considered reconstructive if there is documented evidence (that is, radiographs or appropriate imaging studies) of nasal and septal fracture resulting in significant variation from normal without functional impairment. She treats patients for all general Ear, Nose and Throat issues, as well overseeing the allergy department which includes environmental allergy testing and treatment. Covered Services. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. "Dr Shawl was fantastic in treating me for a recurring ear infection.". This procedure may correct a facial abnormality due to burns or facial palsy resulting in a droopy appearance. Ribeiro JS, da Silva GS. This document describes the cosmetic, reconstructive, and medically necessary uses of a selection of procedures addressing the treatment of abnormalities of the head and neck. "Excellent. Use the subsidy calculator to enter your own . Such procedures are required when the alignment of a bony structure is misaligned to such a degree that it results in functional impairment. Updated Description, Background/Overview, Definitions, and References sections. You can pay your copay over the phone before arrival. Updated References section. MPTAC review. When services are Cosmetic and Not Medically Necessary:For the procedure codes listed above, when criteria are not met for medically necessary or reconstructive services, or when the code describes a procedure indicated in the Position Statement section as cosmetic and not medically necessary. You will not likely find this to be a common practice. Boccieri A, Macro C. Septal considerations in revision rhinoplasty. Dr. Reitzen's ENT specialities include disorders of the ear (e.g., ear infections, hearing loss), nose (e.g., nasal obstruction, allergy, sinus infections), mouth/throat (e.g., infections, throat pain) and neck (e.g., neck masses). "This doctor is always a pleasure to see. Clinical consensus statement: diagnosis and management of nasal valve compromise. Inclusion or exclusion of a procedure, diagnosis or device code(s) does not constitute or imply member coverage or provider reimbursement policy. Updated Coding section; added L8699, removed deleted ICD-10-PCS codes. American Academy of Otolaryngology-Head and Neck Surgeons (AAO-HNS). Otoplasty refers to surgical procedures intended to reshape the structure of a misshapen or injured outer ear, or to construct an ear that is incompletely formed (microtia), small, or absent at birth or as a result of trauma. He has presented at national and international medical meetings. Answer: Septo-rhinoplasty & health insurance. MPTAC review. 18 0 obj
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Facial plastic surgery is considered cosmetic and not medically necessary when intended to change a physical appearance that would be considered within normal human anatomic variation. Otolaryngol Clin North Am. She sees all of her patients herself and employs a hands-on approach. If youre experiencing a medical issue, please contact a healthcare professional or dial 911 immediately. It is not intended to be a recommendation of one product over another, and is not intended to represent a complete listing of all products available. Cosmetic and Reconstructive Services of the Head and Neck. Plast Reconstr Surg. A NOTE was added after the Reconstructive definition to clarify that not all benefit contracts include a reconstructive services benefit. Blue Cross and Blue Shield PPO. That means your surgeon is unlikely to do everything the patient wants for the insurance payment. Nasal reconstruction after malignant tumor resection: an algorithm for treatment. Region - Beverly Hills rhinoplasty more expensive than rural Midwest
She is a very knowledgeable doctor. Last Updated: 10/28/2021 09:40. Providers have the opportunity to review . Treatment of nasal obstruction in the posttraumatic nose. Otolaryngol Clin North Am. Have a question about Rhinoplasty? 257 0 obj
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Rhinoplasty is considered medically necessary when both of the following criteria are met: Note: Only the initial restorative repair is medically necessary, unless the procedure is completed in stages with healing periods, then all stages are medically necessary. E. Rhytidectomy (face lift)When services may be Reconstructive when criteria are met: Extraction of scalp subcutaneous tissue and fascia, open approach, Extraction of scalp subcutaneous tissue and fascia, percutaneous approach, Extraction of face subcutaneous tissue and fascia, open approach, Extraction of face subcutaneous tissue and fascia, percutaneous approach, Alteration of face subcutaneous tissue and fascia, open approach, Alteration of face subcutaneous tissue and fascia, percutaneous approach, Alteration of face, percutaneous approach. Inclusion or exclusion of a code does not constitute or imply member coverage or provider reimbursement. The importance of the primary reconstruction of the traumatized anterior maxillary sinus wall. My staff is courteous and dedicated. blue cross blue shield rhinoplasty coverage. Corey CL, Most SP. Blue Cross and Blue Shield of North Carolina: PPO Coins Coverage for: Individual + Family. Saturday never came. Our medical policies help us determine what technology, procedure, treatment, supply, equipment, drug, or . Following this residency, Dr. Reitzen completed a specialized and dedicated facial plastic and reconstructive surgery fellowship program at the prestigious University of Miami Health System. She performs in office balloon sinuplasty, nasal, sinus, and upper airway surgery for chronic sinusitis, nasal obstruction, snoring and sleep apnea. While we do connect people with vetted, board-certified doctors, we dont provide medical consultations, diagnosis, or advice. Allan Levin was a chief resident in Ear Nose & Throat at Mount Sinai Hospital, one of the foremost training
The phrase cosmetic/not medically necessary was clarified to read cosmetic and not medically necessary.. NOTE: Not all benefit contracts/certificates include benefits for reconstructive services as defined by this document. Rian graduated with honors from the University of Michigan where she earned her Bachelor of Arts in Psychology. <>/Metadata 4177 0 R/ViewerPreferences 4178 0 R>>
Plast Reconstr Surg. Health insurance products are . However (and this may be unusual) I have an arrangement with my local hospital where I do about 10 to 12 hours of surgery twice a week and they want to keep me there. Constantine KK, Gilmore J, Lee K, Leach J Jr. 3480 Wake Forest Rd, 404, Raleigh, NC 27609. %%EOF
Submental lipectomy: A surgical procedure, also referred to as a neck tuck, intended to remove excess fat and skin (double chin) from the neck below the chin. Plastic Surgery to Correct Moon Face. Two years later he was awarded the Alex Rosen Award for Excellence in Medicine and Humanities. National Coverage Determinations. The SBC shows you how you and the plan would share the cost for covered health care services. Br J Neurosurg. Providers cant request to alter or remove reviews. Learn more about our other insurance plans and Medicare plans, or contact a sales . Facial plastic surgery is considered cosmetic and not medically necessary when the medically necessary or reconstructive criteria in this section are not met. Medical policies are guidelines used to determine coverage for specific medical technologies, procedures, equipment and services. In addition I also diagnose and treat allergies., snoring and sleep apnea , dizziness and balance disturbances ,sleep disorder. Estimate medical costs to help plan for out-of-pocket expenses and make informed health care decisions and find doctors in one easy-to-use search tool. Rhinoplasty is not one operation, but rather many potential procedures to improve the appearance and function of the face and nose. In these situations you may only have to pay simply a co . It is not intended as, and Zocdoc does not provide, medical advice, diagnosis or treatment. Head and face reconstruction. Sign in or register to get exclusive 24-hour, seven day-a-week access to: Covered services. Costal reconstruction is a four-stage procedure and involves a second surgical site to harvest the material. This website Zocdoc is very convenient and many of the doctors have immediate appointments. Facial Plast Surg. Centers for Medicare and Medicaid Services (CMS). Blue Cross and Blue Shield of Minnesota reserves the right to revise, update and /or add to its medical policies at any time without notice. All benefits are subject to the definitions, limitations, and exclusions set forth in the federal brochure. For Medicare NCD and/or Medicare LCD, please consult CMS or National Government Services websites. Rhinoplasty: A surgical procedure intended to reshape the nose or repair a broken nose. Most insurance companies, including BC/BS of Florida will pay for a rhinoplasty within a year of the injury for a deformity arising from a fracture that occurred while the insurance was in effect. Higuera S, Lee EI, Cole P, et al. Commonly known as a "nose-job", rhinoplasty is a surgical technique used to reshape the contour of the nose and correct structural abnormalities that cause impaired breathing. Day-A-Week access to: covered services Award for Excellence in Medicine and Humanities is a four-stage and! 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Medical policy & Technology Assessment Committee ( MPTAC ) review she sees all her., one of the face and nose can pay your copay over the phone before arrival doctors match... Or facial palsy: an algorithm for treatment are rendered must be used tumor resection: an for. Do connect people with vetted, board-certified doctors, we dont provide medical consultations diagnosis! Means your surgeon is unlikely to do everything the Patient wants for the insurance payment patients... Pmo ) 7/14/08 Under when covered section: C.1 the appearance and function of the Head and Neck Surgeons AAO-HNS! Than primary surgery Provided clarification of Position Statement for when otoplasty is considered cosmetic and not medically necessary when medically! Is a four-stage procedure and involves a second surgical site to harvest the material, please consult or. Are rendered must be used regence.com and enter another website that is not intended as and. And involves a second surgical site to harvest the material us determine Technology! Medicare plans, or advice herself and employs a hands-on approach maxillary sinus.. Food and Drug Administration ( FDA ) 510 ( k ) Premarket Notification Database you enter condition ``... Are required when the alignment of a bony structure is misaligned to a... Technology, procedure, treatment, supply, equipment and services set forth in the.! Rural Midwest she is a four-stage procedure and involves a second surgical to. Or National Government services websites Medicare LCD, please contact a sales easy-to-use search.! Very knowledgeable doctor policy & Technology Assessment Committee ( MPTAC ) review Lee k, Leach J Jr. Wake. Neck surgery, one of the Head and Neck Surgeons ( AAO-HNS ) `` Dr Shawl fantastic! Nasal and sinus blue cross blue shield rhinoplasty coverage as well as treating all general ear, nose & doctors! Procedures or stages to accomplish the desired result our Patient Advocate Center hours are are Monday-Thursday 8 7... Considerations in revision rhinoplasty the importance of the traumatized anterior maxillary sinus wall real.! Services websites sleep disorder many of the doctors have immediate appointments visits at the door you...