Facial Plast Surg. 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. A NOTE was added after the Reconstructive definition to clarify that not all benefit contracts include a reconstructive services benefit. Pluijmers BI, Caron CJ, Dunaway DJ, et al. An Independent Licensee of the Blue Cross and Blue Shield Association Septoplasty and Reference Sources" revised to indicate correct manual title. 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. In 1992, Dr. Burnett won the NYU Presidents Award for Volunteerism and Community Service. the procedure is reasonably expected to improve the functional impairment; an audiogram documents a loss of at least 15 decibels in the affected ear(s). Updated formatting in Position Statement section. You can search for Blue Cross Blue Shield Ear, Nose & Throat Doctors by symptom or visit reason. %PDF-1.5 % %PDF-1.7 Dr. The document header wording updated from Current Effective Date to Publish Date. Updated References and Websites sections. Otoplasty: the experience of 100 consecutive patients. The cost of cosmetic surgery involves several charges for the entire service. Providers cant request to alter or remove reviews. Most of her surgeries are nasal and sinus procedures and she currently uses balloon sinusplasties to augment standard sinus procedures. Nasal trauma and the deviated nose. Rian also has trained in head and neck aesthetics, providing treatment for facial wrinkles and lax skin with injectibles and skin rejuvenation procedures. Dr. Mourad was then selected from hundreds of exceptional candidates to complete an additional year of aesthetic and advanced facial plastics and reconstructive surgery training with the world-renowned surgeon Dr. Yadranko Ducic. 2010; 126(1):97-105. These reconstructive surgical procedures are also performed to address an individuals significantly altered appearance in the treatment of congenital or acquired facial palsy. If youre not sure which plan you have, you can use Zocdocs insurance checker to find out. Dr. Reitzen completed her undergraduate B.A. Updated References section. She then attended the NYU School of Medicine, where she obtained her MD degree with Honors relating to her research in neurophysiology. Eligible for Medi-Cal Get the care you need with Blue Shield of California Promise Health Plan. Updated References and Websites sections. 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. Covered benefits. Updated References and Index. The coverage eligibility of medical and surgical therapies to treat head and neck abnormalities is often based on a determination of whether the abnormality is considered medically necessary, reconstructive or cosmetic in nature. Federal and State law, as well as contract language, including definitions and specific contract provisions/exclusions, take precedence over Medical Policy and must be considered first in determining eligibility for coverage. Make an appointment online instantly with Plastic Surgeons that accept Blue Cross Blue Shield insurance. Removed ICD-9 codes from Coding section. Allan Levin was a chief resident in Ear Nose & Throat at Mount Sinai Hospital, one of the foremost training Coverage Information. Your member ID card is your key to using your medical plan benefits. Magnetic Resonance Cholangiopancreatography (MRCP) Magnetic Resonance Imaging (MRI) of Neck, Face, Orbit. 2023 Plan documents. 2011; 36(2):106-113. Plast Reconstr Surg. Applicable to Commercial HMO members in California: When a medical policy states a procedure or treatment is investigational, PMGs should not approve or deny the request. Surgeon - Some plastic surgeons charge significantly more or less than their peers. 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. Call 217.391.7086 to get your questions answered and discuss financial options. 30420. 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.. Other procedures are not done to correct a functional impairment. endobj 2012; 26(4):438-444. arma 3 dynamic universal war system change map arma 3 dynamic universal war system change map Some state or federal mandates (e.g., Federal Employee Program [FEP]) prohibits plans from . % Yetiser S, Karapinar U. Hypoglossal-facial nerve anastomosis: a meta-analytic study. Many Blue Cross Blue Shield Ear, Nose & Throat Doctors offer appointments on Saturdays and Sundays. Take care of them with a health plan that offers the coverage . All benefits are subject to the definitions . These surgeries are not reconstructive in nature but are performed for cosmetic purposes. Please refer to. - "Recurrent purulent sinusitis (more than 3 episodes per year) resulting from in middle meatus complex obstruction . Otolaryngol Clin North Am. Rhee JS, Arganbright JM, McMullin BT, Hannley M. Evidence supporting functional rhinoplasty or nasal valve repairs: a 25-year systematic review. I am a member of the Bronx County Medical Society. 2010; 65(6):528-534. Rhinoplasty is a surgical procedure to repair or reshape the nose. 1 0 obj American Academy of Otolaryngology-Head and Neck Surgeons (AAO-HNS). Ducic Y. Reconstruction of the scalp. 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. Rhinology. Microtia may be found in congenital conditions such as Goldenhar syndrome, hemifacial microsomia, and Treacher-Collins syndrome. Otoplasty is considered cosmetic and not medically necessary when intended to change a physical appearance that would be considered within normal human anatomic variation. Each person's unique clinical circumstances may warrant individual consideration, based on review of applicable medical . Lasers Surg Med. Otolaryngol Clin North Am. Check Eligibility. 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. Its simple, secure and free. Zocdoc connects me with capable caring specialists in varied fields when I need them, saving time, fending off anguish and confusion. In the absence of a national coverage determination, coverage decisions are left to the discretion of local Medicare carriers. Health insurance products are . 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. Providers have the opportunity to review . Blue Cross and Blue Shield of Kansas offers a variety of health and dental insurance plans for individuals, families and employers located in Kansas. Any internal breathing issues can be addressed as well and is submitted to insurance; for repair and straightening of the internal nose to its pre-injury state. This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. Dr. Lessow and Rian are both strong proponents of taking the time to educate their patients on their symptoms; they feel the patients' understanding of their medical problems is just as vital to their wellness as the medical and surgical treatment they can provide. As a medical student at NYU, Dr. Burnett launched NYU School of Medicines African Medical Textbook Project, which aimed to provide African medical schools and libraries with new and used science textbooks. "Excellent. The Blue Cross and Blue Shield Association does not intend by the FEP Medical Policy Manual, or by any particular medical policy, to recommend, advocate, . Facial Plast Surg. She is affiliated with New York University Langone Medical Center, Northwell Health -- Lenox Hill Hospital and Hackensack University Medical Center. Dr. Bentsianov completed his clinical training at Downstate Medical Center/ Long Island College Hospital as an intern in General Surgery followed by a residency and chief residency in Otolaryngology- Head and Neck Surgery. Note that services with specific coverage criteria may be reviewed retrospectively to determine if criteria are being met. Br J Neurosurg. Facial Plast Surg Clin North Am. D.Rhinoplasty or Rhinoseptoplasty (procedure which combines both rhinoplasty and septoplasty). Understanding the nasal airway: principles and practice. 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. Before making a final decision, please read the Plans federal brochure (RI 71-005). He currently serves in several high-profile positions. You will have your temperature taken at the door before you enter. We believe Texas consumers and employers deserve the best of both worlds: access to affordable, quality health care and top-notch service from a company that focuses solely on customers, not shareholders. Dr. Loft also specializes in the evaluation and treatment of snoring and obstructive sleep apnea, hearing loss and ear problems, throat and voice disorders and thyroid and parathyroid disease. A structural abnormality displaces the nasal structure, resulting in fixed, medically significant airway obstruction that medical therapy has failed to correct; Performed on an eligible dependent child who has a congenital disease or anomaly that has caused a functional defect (e.g. K143173. If you have fever, headache, muscle aches, shortness of breath, sore throat, cough or fatigue please call the office for a telemedicine apt. Facial plastic surgery is a general term for any surgery performed for the purpose of altering the appearance of the face. 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. "She was very clear in giving me feedback and answering my questions,". A review of practical guidelines for the correction of deviated, asymmetric nose. "Very happy. Blue Cross Blue Shield of Massachusetts also offers insurance, pharmacy coverage, and Medicare Plans for seniors; life and disability insurance through Indigo Insurance Services (a wholly owned subsidiary); and insurance for individuals aged 18-26 years. [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 . Rhinoplasty for any other indication is considered cosmetic and, therefore, not covered. 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. If the member's contract benefits differ from the medical policy, the contract . Blue Shield of California 601 12 th Street, Oakland, CA 94607 . Core services include full coverage for preventive care, the first 10 office visits per year with a $10.00 copayment for both PCP and specialists. ", "I made an appointement on Thursday November 17th. Ear or body piercing is considered cosmetic and not medically necessary when performed for any reason. Rhinoplasty may be performed to alter the shape of the nose to improve the passage of air while breathing (from blocked nasal passages or severe nasal obstruction), or to correct structural damage due to disease or trauma (for example, to repair a nasal fracture) without involvement of the underlying nasal septa. 2009; 42(3):495-511. 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. taking thorough histories that enable him to diagnose accurately while making his patients know that their Details of Dr. Huang's 19 years experience as an MD, his hospital affiliation and education at Yeshiva University. Facial Plast Surg. 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. NCD #140.4. There are 3 sets of turbinates on each side of the nose. Wednesday was spend finding a Dr. who was nice enough to send a partial to Walgreens and asked why this other Dr. didn't do the same. See all nearby highly-recommended providers. "To the point and very professional. Blue Cross and Blue Shield of North Carolina: PPO Coins Coverage for: Individual + Family. 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. International healthcare coverage is available for employers, individuals and students, providing peace of mind for everyone from . Dr. Bentsianovs clinical interests are centered on the evaluation and treatment of disorders of the larynx by various endoscopic, stroboscopic and electromyographic techniques, as well as laryngeal framework surgery. A treatment strategy for postburn neck reconstruction: emphasizing the functional and aesthetic importance of the cervicomental angle. 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