Medicare Advantage Prior Authorization |
Reconstructive and Plastic Surgery | last updated 12/01/2009 garcarl |
15821 | Blepharoplasty, lower eyelid; with extensive herniated fat pad |
15822 | Blepharoplasty, upper eyelid; |
15823 | Blepharoplasty, upper eyelid; with excessive skin weighting down lid |
15824 | Rhytidectomy; forehead |
15826 | Rhytidectomy; glabellar frown lines |
15830 | Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy |
17106 | Destruction of cutaneous vascular proliferative lesions (eg, laser technique); less than 10 sq cm |
17107 | Destruction of cutaneous vascular proliferative lesions (eg, laser technique); 10.0 to 50.0 sq cm |
17108 | Destruction of cutaneous vascular proliferative lesions (eg, laser technique); over 50.0 sq cm |
19300 | Mastectomy for gynecomastia |
19316 | Mastopexy |
19318 | Reduction mammaplasty |
19324 | Mammaplasty, augmentation; without prosthetic implant |
19325 | Mammaplasty, augmentation; with prosthetic implant |
19328 | Removal of intact mammary implant |
19330 | Removal of mammary implant material |
19355 | Correction of inverted nipples |
19370 | Open periprosthetic capsulotomy, breast |
19371 | Periprosthetic capsulectomy, breast |
67900 | Repair of brow ptosis (supraciliary, mid-forehead or coronal approach) |
67901 | Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia) |
67902 | Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia |
67903 | Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach |
67904 | Repair of blepharoptosis; (tarso) levator resection or advancement, external approach |
67906 | Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia) |
67908 | Repair of blepharoptosis; conjunctivo-tarso-Muller's muscle-levator resection (eg, Fasanella-Servat type) |
67909 | Reduction of overcorrection of ptosis |
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