Head and face reconstruction. Dr. Reitzen is double board certified by the American Board of Otolaryngology Head and Neck Surgery and the American Board of Facial Plastic and Reconstructive Surgery. Clin Otolaryngol. Retrospective denial of claims may result if criteria are not met. For the past twenty 25 years, I have diagnosed and treated diseases of the ear,nose and throat. hb```f``b`a`g`@ +P^3@ZVpxt0[t@1:XX$i(NwjK`kXP] b7co drH3 Dr. This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jersey's Health Insurance Marketplace. He listened to my concerns and tried to address it.". 0 Health insurance products are . Note that services with specific coverage criteria may be reviewed retrospectively to determine if criteria are being met. The cost of cosmetic surgery involves several charges for the entire service. A prefabricated device is typically comprised of 2 pieces, which are then trimmed and custom fitted to size using the template and assembled using sutures or welds (Constantine, 2014). NOTE: Not all benefit contracts/certificates include benefits for reconstructive services as defined by this document. January 20, 2016. Updated References, Websites for Additional Information, and Index. These procedures are expected to improve the individuals functions involving speech, nutrition, control of secretions, corneal protection, or airway protection. These Medical Policies serve as guidelines for health care benefit coverage decisions, which may vary according to the different products and benefit plans offered by BCBSIL. 2019; 35(4):377-386. Corey CL, Most SP. 2009; 42(3):567-578. In 1992, Dr. Burnett won the NYU Presidents Award for Volunteerism and Community Service. I broke my nose a few weeks ago and my doctor said I should get a septorhinoplasty. Note: Rhinoseptoplasty is considered medically necessary when the criteria above for rhinoplasty are met and medically necessary criteria in CG-SURG-18 Septoplasty are also met. Rhinoplasty is a surgical procedureto repair or reshape the nose. Can I get BCBS to consider a complete reshaping of my entire nose as the "reconstruction" of my nose? Rhinoplasty with Nasal Reconstruction, Preauthorization via the Web-Based Tool for Procedures . He has presented at national and international medical meetings. Dr. Lam has been involved in research throughout his academic career. Summary of Safety and Effectiveness. Examples include, but are not limited to, reconstructive procedures which correct or improve a significant functional impairment of speech, nutrition, control of secretions, protection of the airway, or corneal protection. J Oral Maxillofac Surg. Dental diagnostic and preventive services. endobj Two years later he was awarded the Alex Rosen Award for Excellence in Medicine and Humanities. Our medical policies help us determine what technology, procedure, treatment, supply, equipment, drug, or . The cause of rhinophyma is unknown, but has been associated with long standing rosacea, a chronic skin rash that is characterized by reddening of the skin on the face. Under Basic Option, benefits are not available for services performed by Non-preferred providers, except in certain situations such as emergency care. x}xG.k7{w5 D69&dm`{Q"#9$A"@(tt&!A{_5\uNe]tE]tE]tE]tE]tE]tE]tE]tE]tE]tE]tE]tE]tE]tE]tE]tE]tE]tE]tE]tE]tE_B$~b~/4u,[|"lb%Wm{ This website Zocdoc is very convenient and many of the doctors have immediate appointments. Contract / Summary of Benefits & Coverages. (N4M&Z!)%VXpf8:<36qfSR2e2-18f=N0kf9sfVBC2aV1If(I \zXbJ(C9SmvT-z.f&KAqbNA6hHt$(Z5XE6Lh)$Z1XB3.Oqmi8Jp}0#%`ZtD;Y1:Y3;0m:Iu[3SlxttXl)VVpILdv::g nU~{6jXMv4. Added a cosmetic and not medically necessary statement to the section: Facial Plastic Surgery. Covered benefits. Always contact your healthcare provider directly with any questions you may have regarding your health or specific medical advice. Blue Cross Blue Shield Association and the Office of Personnel Management in Washington, D.C. FEP utilizes the Blue Choice PPO network. Mehta RP. Osteotomy/Osteoplasty: A surgical procedure that involves the opening of a bone (osteotomy), or to reconfigure a bone (osteoplasty). Please review the terms of use and privacy policies of the new site you will be visiting. [The plans offered here do not offer pediatric dental coverage and you want to choose a QHP offered by a different issuer that covers pediatric dental services or a . Find Blue Cross Blue Shield Plastic Surgeons & Providers with verified reviews. Many Blue Cross Blue Shield Ear, Nose & Throat Doctors offer appointments on Saturdays and Sundays. She said no problem, Walgreens would have my meds Saturday. Dr. Mourad is internationally renowned and highly sought after for his expertise in facial plastic surgery, reconstructive, nasal, and sinus surgery. After performing almost 2000 endoscopic Otolaryngol Head Neck Surg. The following codes for treatments and procedures applicable to this document are included below for informational purposes. 2007; 120(7 Suppl 2):64S-75S. My practice is to incorporate any reasonable patient request into the procedure. No go. Rhinoplasty is consideredCOSMETIC for all other indications. "@\k ,Awb@!b``&Q@ Jr? It's free! Every patient must arrive with a mask/ nose and mouth covering. When services are Cosmetic and Not Medically Necessary:For the procedure codes listed above when criteria are not met for medically necessary services, or when the code describes a procedure indicated in the Position Statement section as cosmetic and not medically necessary. Add your insurance to see in-network doctors. Otoplasty is considered cosmetic when there is no functional impairment or trauma involved, but may be reconstructive or medically necessary in instances where the ear is misshapen enough to interfere with normal hearing, is absent at birth, or is deformed due to disease or trauma. Rhinoseptoplasty may also be performed as a reconstructive procedure to correct a nasal and septal fracture resulting in significant variation from normal without functional impairment. For both techniques, a template is devised from radiographs of the normal ear, or of a family members ear in the case of bilateral microtia. Our AskBlueSMFEP Medical Plan Finder tool can help you select the right option for your needs. 30410. ", "Great physician. Please refer to, This document does not address surgical procedures involving the mandible, maxilla (or both) or genioplasty procedures. 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. Surgical treatment of facial paralysis. . Howard BK, Rohrich RJ. Facial plastic surgery is considered reconstructive when intended to address a significant variation from normal related to accidental injury, disease, trauma, or treatment of a disease or congenital defect.Note: The initial restoration may be completed in stages. Dr. Shari Reitzen is an adult ENT/Facial Plastic Surgeon who is double board certified in Otolaryngology-Head and Neck Surgery and Facial Plastic and Reconstructive Surgery. If Springfield Clinic is out-of-network for your insurance plan, call us to discuss whether our self-pay options may help you manage costs. MPTAC review. Region - Beverly Hills rhinoplasty more expensive than rural Midwest Updated Coding section; added L8699, removed deleted ICD-10-PCS codes. 70 0 obj <>stream Anthem BlueCross BlueShield Wisconsin is the largest health insurance company in the state with over 5 million members in all 254 Wisconsin counties. Otoplasty is considered reconstructive when intended to restore the absence of the external ear due to accidental injury, disease, trauma, or the treatment of a disease or congenital defect. If youre not sure which plan you have, you can use Zocdocs insurance checker to find out. Septoplasty is an internal procedure which does not affect the outward appearance of the nose, is usually performed to improve breathing, but may also be performed to assist in the management of polyps, tumors or epistaxis. After becoming a diplomate of the American Board of Otolaryngology- Head and Neck Surgery he rejoined the faculty of SUNY Downstate in June 2003 as assistant professor in the Department of Otolaryngology and Director of the Division of Laryngology, Voice and Swallowing Disorders. (please arrive on time so we can accomplish this goal) Reducing complications in rhinoplasty. They are commonly referred to as ENT physicians. Treatment timelines to understand the stages of care, including early evaluations . the medical record documentation includes evidence of the failure of conservative medical therapy for severe airway obstruction from deformities due to disease, structural abnormality, or previous therapeutic process that will not respond to septoplasty alone; the procedure can be reasonably expected to improve the functional impairment. Facial Plast Surg. He is board-certified by the American Board of Otolaryngology Head and Neck Surgery, one of the oldest medical specialties in the country. Lewin S. Complications after total porous implant ear reconstruction and their management. Arch Facial Plast Surg. Saturday never came. Before making a final decision, please read the Plans federal brochure (RI 71-005). Septoplasty, usually performed under local or general anesthesia, is a surgical procedure to correct nasal septum defects or deformities by alteration, splinting, or partial removal of obstructing structures (Note: The indications for septoplasty alone are not addressed in this document). Network Coverage In-network care only, except in certain situations like emergency care Out-of-Pocket Maximum (PPO) . Can my surgeon give me the nose Ive always wanted while getting rid of a bump acquired from injury? Reference sources added. Vascular decompression of trigeminal and facial nerves in the posterior fossa under endoscope-assisted keyhole conditions. He treats many conditions, both cosmetic and complex, that affect the head, neck, and entire facial area. That means your surgeon is unlikely to do everything the patient wants for the insurance payment. Implantation using the implant does not require cartilage harvesting. Zocdoc connects me with capable caring specialists in varied fields when I need them, saving time, fending off anguish and confusion. Covered Services. Ear or body piercing is considered cosmetic and not medically necessary when performed for any reason. Benefit plans vary in coverage and some plans may not provide coverage for certain services addressed in the medical policies. Rians background in Psychology taught her how to use a holistic approach when treating patients. Revision based on Pre-merger Anthem and Pre-merger WellPoint Harmonization. Each member of a Basic Option plan who has Medicare Part A and Part B can get reimbursed up to $800 per year for paying their Medicare Part B premiums. 17106, 17107, 17108. He currently serves in several high-profile positions. Each review must comply with Zocdocs guidelines. Please refer to the member's contract benefits in effect at the time of service to determine coverage or non-coverage of these services as it applies to an individual member. As applicable, review the provisions relating to a specific coverage determination, including exclusions and limitations. . Eileen Raynor completed their Medical School at University Of North Carolina At Chapel Hill School Of Medicine. 51 0 obj <>/Filter/FlateDecode/ID[<7C9FE689D151CEB8B637FAE603B801C0>]/Index[18 53]/Info 17 0 R/Length 141/Prev 138161/Root 19 0 R/Size 71/Type/XRef/W[1 3 1]>>stream 2014; 72(5):959-972. BCBS 27777 ACABlueCare 5000 Rev. @ E/ In individuals with facial injuries due to burns or lax facial muscles due to palsy, the use of rhytidectomy may allow the restoration of a normal appearance. Medical policies are guidelines used to determine coverage for specific medical technologies, procedures, equipment and services. hb```f``*b`e`gd@ A(W| 2Ln PuHC1 CkW?>0`hn9r#PmMkCCCC+C CClRL'4#w1,Q &5 Nasal reconstruction after malignant tumor resection: an algorithm for treatment. Understanding the nasal airway: principles and practice. 2014; 16(4):240-244. The thing is, I have ALWAYS hated my nose. Clarification of Position Statements. Rhee JS, Weaver EM, Park SS, et al. hbbd```b`` qd]fkH IrT_09N\-`hi"3$cp)X< C. Rhinophyma SurgeryWhen services may be Medically Necessary when criteria are met: Excision or surgical planing of skin of nose for rhinophyma. Involves several charges for the insurance payment claims may result if criteria are being met `` \k! 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