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{ Anthem Blue Cross Blue Shield Wisconsin. Miller LE, Miller VM. 2010; 143(1):48-59. The intent of the surgery is to correct the deformity caused by the nasal and septal fracture. Every provider that appears in search is open to new patients. ,Nn~U. Updated References and Index. Medicare for Michigan. 2023 Plan documents. Rhinoplasty is not one operation, but rather many potential procedures to improve the appearance and function of the face and nose. Dr. 2001; 108(4):1045-1053. Becker DG, Becker SS. Examples of cranial nerve procedures to correct a functional impairment include, but are not limited to, procedures to allow for speech, nutrition, control of secretions, protection of the airway, or corneal protection. $15copay all additional visits, Inpatient (Precertification is required): $250per day copay; up to $1,500per admission, Earn $50 for completing the Blue Health Assessment3. Moolenburgh SE, McLennan L, Levendag PC, et al. MPTAC review. She then attended the NYU School of Medicine, where she obtained her MD degree with Honors relating to her research in neurophysiology. 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. See what the #1 health plan for federal employees can do for you. J Oral Maxillofac Surg. The program was constructed as a joint venture of the NYU School of Medicine, U.S. State Department, textbook publishers, and corporate philanthropists. [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 . 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. His topical intranasal solution medications are Zocdoc verifies all providers before they can appear in Zocdoc search results. OT services emphasize useful and purposeful . If you are in distress please go to the nearest ER or call 911. Blue Shield of California 601 12 th Street, Oakland, CA 94607 . Zocdoc let's you see real-time availability for Blue Cross Blue Shield Ear, Nose & Throat Doctors. Dr. Burnett is a member of American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Board of Internal Medicine, and the American Medical Association. He has raised four children. Ear or body piercing is considered cosmetic and not medically necessary when performed for any reason. To find the newest version, go to https://www.bluecrossmn.com/providers/medical-policy-and-utilization-management, read and accept the Blue Cross Medical Policy Statement, then select Blue Cross and Blue Shield of Minnesota Medical Policies. This will bring up the Medical Policy search screen. Learn more. We can NOT diagnose or treat Covid 19 in this office. D. Rhinoplasty or Rhinoseptoplasty (procedure which combines both rhinoplasty and septoplasty) . programs in America, after his graduation from Downstate Medical School. Before making a final decision, please read the Plans federal brochure (RI 71-005). 3 0 obj Otoplasty is considered cosmetic and not medically necessary when the medically necessary or reconstructive criteria in this section are not met. Rian is a member of the Society of Physician Assistants in Otorhinolaryngology-Head & Neck Surgery, the Association of PAs in Allergy, Asthma, and Immunology, the American Academy of Physician Assistants, and the New York State Society of Physician Assistants. Also document that the beak have caused the deformity and that the surgery is to correct the deformity as a result of the trauma. In the majority of cases a septoplasty is covered by most PPO insurances and Medicare as it is causing significant medical issues like chronic nasal obstruction, recurrent sinus infections, sinus headaches, chronic mouth breathing/snoring, recurrent nosebleeds or various other symptoms. Microsurgical repair of peripheral trigeminal nerve injuries from maxillofacial trauma. No referrals! 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. The content provided here and elsewhere on the Zocdoc site or mobile app is provided for general informational purposes only. Arch Facial Plast Surg. Revised section title and cosmetic and not medically necessary statement related to: A. Facial Plastic Surgery: (including, but not limited to, submental lipectomy); clarified reconstructive and cosmetic and not medically necessary statements: B. Otoplasty. Zocdoc only allows patients to write reviews if we can verify they have seen the provider. 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. Dr. Reitzen's facial plastic surgical specialties include: non-surgical facial rejuvenation such as Botox and injectable fillers (Juvederm, Restylane, Belotero, Radiesse), rhinoplasty, facelifts, blepharoplasty (eyelid surgery), brow surgery, otoplasty (ear pinning), neck liposuction, skin cancer reconstruction, excision of scars/moles, and facial trauma and reconstruction. The staff was very pleasant as well.". Same-day appointments are often available, you can search for real-time availability of Ear, Nose & Throat Doctors who accept Blue Cross Blue Shield insurance and make an appointment online. Complexity - Full rhinoplasty treating many parts of the nose and requiring anesthesia is more expensive than simple procedures isolated to specific areas which may be performed with local anesthesia Rhytidectomy: A surgical procedure intended to adjust the appearance of the face by removing excess skin and tightening the underlying muscles. Revision of Position Statement for reconstructive rhinoplasty for nasal fractures. 2002; 16(5):243-248. $0 for first 2 visits You want to enroll members of your household in separate QHPs. Available at. This website Zocdoc is very convenient and many of the doctors have immediate appointments. Medical policies are scientific documents that define the technologies, procedures, and treatments that are considered medically necessary, not medically necessary, and investigational link to investigational policy. "To the point and very professional. After performing almost 2000 endoscopic She sees all of her patients herself and employs a hands-on approach. 2014; 72(5):959-972. % That means your surgeon is unlikely to do everything the patient wants for the insurance payment. "As usual, Dr. Burnett was thorough, friendly and effective. Dr. Szubin lives in New York with her husband and three children. @ E/ Ann Plast Surg. Otolaryngol Head Neck Surg. <> In addition, face lifts are used to create a more youthful appearance in individuals concerned with changes due to the aging process. These policies state whether a procedure, biologic, treatment/therapy, or device is or is not medically necessary or investigational. (N4M&Z!)%VXpf8:<36qfSR2e2-18f=N0kf9sfVBC2aV1If(I \zXbJ(C9SmvT-z.f&KAqbNA6hHt$(Z5XE6Lh)$Z1XB3.Oqmi8Jp}0#%`ZtD;Y1:Y3;0m:Iu[3SlxttXl)VVpILdv::g nU~{6jXMv4. Added reference for Centers for Medicare and Medicaid Services (CMS) National Coverage Determination (NCD). (please arrive on time so we can accomplish this goal) NOTE: Not all benefit contracts/certificates include benefits for reconstructive services as defined by this document. Newark fixed it. Medicaid products and some self-insured plans may have additional policies and prior authorization requirements. Rhinoplasty: A surgical procedure intended to reshape the nose or repair a broken nose. A $500/individual and Can my surgeon give me the nose Ive always wanted while getting rid of a bump acquired from injury? When services are 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 not medically necessary. Reordered text and updated Background/Overview. Inclusion or exclusion of a procedure, diagnosis or device code(s) does not constitute or imply member coverage or provider reimbursement policy. . Note: Please see the following documents for additional information: Note: The use of botulinum toxin is not addressed in this document. One patient will be in the office at a time. Rhytidectomy is considered cosmetic and not medically necessary when the reconstructive criteria in this section are not met, including, but not limited to, removal of wrinkles, excess skin, or to tighten facial muscles. <>/Metadata 4177 0 R/ViewerPreferences 4178 0 R>> She performs in office balloon sinuplasty, nasal, sinus, and upper airway surgery for chronic sinusitis, nasal obstruction, snoring and sleep apnea. Medical Policy & Technology Assessment Committee (MPTAC) review. She then attended Cornell University Medical Center and trained at Manhattan Eye, Ear, and Throat Hospital, the Lenox Hill Hospital, the New York Hospital, and the Memorial-Sloan Kettering Hospital during her six-year residency. 2012; 26(4):438-444. 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.. Rhinoseptoplasty, involving both rhinoplasty and septoplasty, is a more extensive surgical procedure combining repairs to the external nasal pyramid or skeleton with repairs of the nasal septa to correct a functional impairment involving both structures. %PDF-1.5 % Dr. Mourad is internationally renowned and highly sought after for his expertise in facial plastic surgery, reconstructive, nasal, and sinus surgery. This condition typically affects male Caucasians over 40 years of age, although some cases have been reported in women and younger individuals. There are 3 sets of turbinates on each side of the nose. I studied at the University of Santo Tomas medical school and then completed my residency in Otolaryngology at Kings County Hospital. Add your insurance to see in-network doctors. Blue Cross and Blue Shield of Kansas offers a variety of health and dental insurance plans for individuals, families and employers located in Kansas. Surgical treatment of facial paralysis. Dr. Lam feels that as a Facial Plastic Surgeon, it is imperative to be a diligent student of facial anatomy. After graduating with her Masters Degree in Physician Assistant Studies from Rutgers University, Rian was trained extensively under the direct supervision of top otolaryngology physicians to provide unparalleled care and treatment in the field of Ear Nose and Throat Head and Neck surgery. hb```f``*b`e`gd@ A(W| 2Ln PuHC1 CkW?>0`hn9r#PmMkCCCC+C CClRL'4#w1,Q &5 Find a plan that works for you. endobj Most of her surgeries are nasal and sinus procedures and she currently uses balloon sinusplasties to augment standard sinus procedures. Plast Reconstr Surg. Enter the policy number without the version number (last 3 digits). F. Cranial Nerve ProceduresWhen services may be Medically Necessary or Reconstructive when criteria are met: Graft for facial nerve paralysis [includes codes 15840, 15841, 15842, 15845], Neuroplasty and/or transposition; cranial nerve, Transection or avulsion (nerves of face) [includes codes 64732, 64734, 64736, 64738, 64740, 64742], Suture of facial nerve [includes codes 64864, 64865], Anastomosis (facial nerves) [includes codes 64866, 64868], Total facial nerve decompression and/or repair (may include graft), Release oculomotor nerve [by approach; includes codes 00NH0ZZ, 00NH3ZZ, 00NH4ZZ], Release trochlear nerve [by approach; includes codes 00NJ0ZZ, 00NJ3ZZ, 00NJ4ZZ], Release trigeminal nerve [by approach; includes codes 00NK0ZZ, 00NK3ZZ, 00NK4ZZ], Release abducens nerve [by approach; includes codes 00NL0ZZ, 00NL3ZZ, 00NL4ZZ], Release facial nerve [by approach; includes codes 00NM0ZZ, 00NM3ZZ, 00NM4ZZ], Repair oculomotor nerve [by approach; includes codes 00QH0ZZ, 00QH3ZZ, 00QH4ZZ], Repair trochlear nerve [by approach; includes codes 00QJ0ZZ, 00QJ3ZZ, 00QJ4ZZ], Repair trigeminal nerve [by approach; includes codes 00QK0ZZ, 00QK3ZZ, 00QK4ZZ], Repair abducens nerve [by approach; includes codes 00QL0ZZ, 00QL3ZZ, 00QL4ZZ], Repair facial nerve [by approach; includes codes 00QM0ZZ, 00QM3ZZ, 00QM4ZZ], Reposition oculomotor nerve [by approach; includes codes 00SH0ZZ, 00SH3ZZ, 00SH4ZZ], Reposition trochlear nerve [by approach; includes codes 00SJ0ZZ, 00SJ3ZZ, 00SJ4ZZ], Reposition trigeminal nerve [by approach; includes codes 00SK0ZZ, 00SK3ZZ, 00SK4ZZ], Reposition abducens nerve [by approach; includes codes 00SL0ZZ, 00SL3ZZ, 00SL4ZZ], Reposition facial nerve [by approach; includes codes 00SM0ZZ, 00SM3ZZ, 00SM4ZZ], Transfer olfactory nerve [by destination and approach; includes codes 00XF0ZH, 00XF0ZJ, 00XF0ZK, 00XF0ZL, 00XF0ZM, 00XF4ZH, 00XF4ZJ, 00XF4ZK, 00XF4ZL, 00XF4ZM], Transfer optic nerve [by destination and approach; includes codes 00XG0ZH, 00XG0ZJ, 00XG0ZK, 00XG0ZL, 00XG0ZM, 00XG4ZH, 00XG4ZJ, 00XG4ZK, 00XG4ZL, 00XG4ZM], Transfer oculomotor nerve [by destination and approach; includes codes 00XH0ZH, 00XH0ZJ, 00XH0ZK, 00XH0ZL, 00XH0ZM, 00XH4ZH, 00XH4ZJ, 00XH4ZK, 00XH4ZL, 00XH4ZM], Transfer trochlear nerve [by destination and approach; includes codes 00XJ0ZH, 00XJ0ZJ, 00XJ0ZK, 00XJ0ZL, 00XJ0ZM, 00XJ4ZH, 00XJ4ZJ, 00XJ4ZK, 00XJ4ZL, 00XJ4ZM], Transfer trigeminal nerve [by destination and approach; includes codes 00XK0ZH, 00XK0ZJ, 00XK0ZK, 00XK0ZL, 00XK0ZM, 00XK4ZH, 00XK4ZJ, 00XK4ZK, 00XK4ZL, 00XK4ZM], Transfer abducens nerve [by destination and approach; includes codes 00XL0ZH, 00XL0ZJ, 00XL0ZK, 00XL0ZL, 00XL0ZM, 00XL4ZH, 00XL4ZJ, 00XL4ZK, 00XL4ZL, 00XL4ZM], Transfer facial nerve [by destination and approach; includes codes 00XM0ZH, 00XM0ZJ, 00XM0ZK, 00XM0ZL, 00XM0ZM, 00XM4ZH, 00XM4ZJ, 00XM4ZK, 00XM4ZL, 00XM4ZM], Transfer acoustic nerve [by cranial nerve destination and approach; includes codes 00XN0ZH, 00XN0ZJ, 00XN0ZK, 00XN0ZL, 00XN0ZM, 00XN4ZH, 00XN4ZJ, 00XN4ZK, 00XN4ZL, 00XN4ZM], Transfer glossopharyngeal nerve [by cranial nerve destination and approach; includes codes 00XP0ZH, 00XP0ZJ, 00XP0ZK, 00XP0ZL, 00XP0ZM, 00XP4ZH, 00XP4ZJ, 00XP4ZK, 00XP4ZL, 00XP4ZM], Transfer vagus nerve [by cranial nerve destination and approach; includes codes 00XQ0ZH, 00XQ0ZJ, 00XQ0ZK, 00XQ0ZL, 00XQ0ZM, 00XQ4ZH, 00XQ4ZJ, 00XQ4ZK, 00XQ4ZL, 00XQ4ZM], Transfer accessory nerve [by cranial nerve destination and approach; includes codes 00XR0ZH, 00XR0ZJ, 00XR0ZK, 00XR0ZL, 00XR0ZM, 00XR4ZH, 00XR4ZJ, 00XR4ZK, 00XR4ZL, 00XR4ZM], Transfer hypoglossal nerve [by cranial nerve destination and approach; includes codes 00XS0ZH, 00XS0ZJ, 00XS0ZK, 00XS0ZL, 00XS0ZM, 00XS4ZH, 00XS4ZJ, 00XS4ZK, 00XS4ZL, 00XS4ZM].
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