%PDF-1.4 Nasal reconstruction after malignant tumor resection: an algorithm for treatment. Updated References section. You can search for Blue Cross Blue Shield Ear, Nose & Throat Doctors by symptom or visit reason. 30400. You will not likely find this to be a common practice. The aforementioned legal entities (excepting First Care, Inc. of Maryland), CareFirst BlueChoice, Inc., and The Dental Network, Inc., are independent licensees of the Blue Cross and Blue Shield Association. 1 0 obj 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. Updated References. 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. Also document that the beak have caused the deformity and that the surgery is to correct the deformity as a result of the trauma. Moved term submental lipectomy to neck tuck within position statement. About Us. voice and throat problems, and balance and dizziness symptoms. Many of our plans offer $0 premiums, $0 deductibles and $0 primary care copays, while others combine medical and dental coverage. Palsy: A condition affecting the nerves that results in the inability of voluntary movement (motor function) or paralysis, generally partial, of a body area. C. Rhinophyma SurgeryWhen services may be Medically Necessary when criteria are met: Excision or surgical planing of skin of nose for rhinophyma. You will have your temperature taken at the door before you enter. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. Sinusitis: Inflammation of the sinuses. Note: Please see the following documents for additional information: Note: The use of botulinum toxin is not addressed in this document. Basically, if I am already doing a septoplasty paid for by insurance the hospital charges a very minimal fee and anesthesia does not (so far) charge extra and I charge the patient a discounted fee for a cash payment to do the rhinoplasty - recent fracture or not. Before making a final decision, please read the Plans federal brochure (RI 71-005). @ E/ 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. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 15 0 R 24 0 R 29 0 R 44 0 R 45 0 R 48 0 R 49 0 R 50 0 R 51 0 R 52 0 R 53 0 R 54 0 R 55 0 R 56 0 R 57 0 R 58 0 R 59 0 R 60 0 R 63 0 R 64 0 R 65 0 R 66 0 R 67 0 R 68 0 R 69 0 R 70 0 R 71 0 R 72 0 R 73 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Clinical consensus statement: diagnosis and management of nasal valve compromise. He is board-certified by the American Board of Otolaryngology Head and Neck Surgery, one of the oldest medical specialties in the country. If youre not sure which plan you have, you can use Zocdocs insurance checker to find out. Medically Necessary: In this document, procedures are considered medically necessary if there is a significant functional impairment AND the procedure can be reasonably expected to improve the functional impairment. 2014; 43(3):286-295. Rhinology. Inclusion or exclusion of a code does not constitute or imply member coverage or provider reimbursement. 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. He has been in private practice in New York for more than 20 years as well as active in academic otolaryngology including resident training and surgical supervision. 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. 18 0 obj <> endobj 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]. A rhytidectomy or face lift is a surgical procedure where excess skin is removed from the face and the facial muscles are tightened. The online Medical Policy Reference Manual contains approved medical policies and operating procedures for all products offered by CareFirst. You can also filter your search results to show only Ear, Nose & Throat Doctors who offer video visits. ", "I made an appointement on Thursday November 17th. cleft palate) as determined by the attending physician; Incidental to or following another surgery that was needed because of injury, sickness or disease of that part of the body. Healthy Blue is our health plan for Medicaid members. NOTE: Not all benefit contracts/certificates include benefits for reconstructive services as defined by this document. 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. Plast Reconstr Surg. Dr. Szubin is also using new drug-eluting stents during sinus surgery, which is beneficial and cutting-edge. Anthem Blue Cross Blue Shield Wisconsin. 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. Medical policies, which are based on the most current research available at the time of policy development, state whether a medical technology, procedure, drug or device is: If you have fever, headache, muscle aches, shortness of breath, sore throat, cough or fatigue please call the office for a telemedicine apt. Rhinoplasty is considered reconstructive if there is documented evidence (that is, radiographs or appropriate imaging studies) of nasal fracture resulting in significant variation from normal without functional impairment. Each person's unique clinical circumstances may warrant individual consideration, based on review of applicable medical . You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Becker DG, Becker SS. Rhinoplasty with Nasal Reconstruction, Preauthorization via the Web-Based Tool for Procedures . The total fees may also include cost of surgical supplies, laboratory tests, anesthesia, and hospital operating room charges, in addition to the surgeon's fee for performing the cosmetic surgery. Blue Cross and Blue Shield PPO. For the past twenty 25 years, I have diagnosed and treated diseases of the ear,nose and throat. IV-73 Rhinoplasty and Septorhinoplasty No New Commercial . A $500/individual and Helped me with treatment plans for my condition.". Your member ID card is your key to using your medical plan benefits. These reconstructive surgical procedures are also performed to address an individuals significantly altered appearance in the treatment of congenital or acquired facial palsy. Dr. Burnett completed his fellowship at the Medical University of South Carolina. 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. Rhinophyma is a condition where the nose becomes enlarged, red in color, and bulb-shaped in appearance. Appropriate surfaces/ instruments will be cleaned between patients 3480 Wake Forest Rd, 404, Raleigh, NC 27609. Concepts of Medical Necessity, Reconstructive and Cosmetic. 2012; 26(4):438-444. D. Rhinoplasty or Rhinoseptoplasty (procedure which combines both rhinoplasty and septoplasty) . Not medically necessary statement added for cranial nerve procedures to align with existing coding. Two years later he was awarded the Alex Rosen Award for Excellence in Medicine and Humanities. Added a cosmetic and not medically necessary statement to the section: Facial Plastic Surgery. Dr. Call 217.391.7086 to get your questions answered and discuss financial options. see the Ear, Nose & Throat Doctor within 24 hours, Blue Cross Blue Shield Ear, Nose & Throat Doctors, find Blue Cross Blue Shield Ear, Nose & Throat Doctors, Blue Cross Blue Shield Therapists/counselors, Benign Paroxysmal Positional Vertigo (BPPV), Jersey City, NJ Ear, Nose & Throat Doctors, Los Angeles, CA Ear, Nose & Throat Doctors, Philadelphia, PA Ear, Nose & Throat Doctors, San Antonio, TX Ear, Nose & Throat Doctors, San Francisco, CA Ear, Nose & Throat Doctors, Washington, DC Ear, Nose & Throat Doctors, UnitedHealthcare Ear, Nose & Throat Doctors, Anthem Blue Cross Blue Shield Ear, Nose & Throat Doctors, UnitedHealthcare Oxford Ear, Nose & Throat Doctors, Empire Blue Cross Blue Shield (Health) Ear, Nose & Throat Doctors, EmblemHealth (formerly known as HIP) Ear, Nose & Throat Doctors, EmblemHealth (formerly known as GHI) Ear, Nose & Throat Doctors, American Board of Facial Plastic and Reconstructive Surgery, Medical School - New York University, Doctor of Medicine, New York University Medical Center, Residency in Otolaryngology and Head and Neck Surgery, University of Miami Health System, Fellowship in Facial Plastic and Reconstructive Surgery, American Academy of Facial Plastic and Reconstructive Surgery, Medical School - State University of New York, Downstate Medical Center, Doctor of Medicine, The Mount Sinai Hospital, Residency in Otolaryngology, American Board of Otolaryngology - Head and Neck, Medical School - Cornell University, Doctor of Medicine, Lenox Hill Hospital, Internship in General Surgery, New York University Medical Center, Residency in Otolaryngology, American Academy of Otolaryngology Head and Neck Surgery, National Commission on Certification of Physician Assistants, Rutgers, The State University of New Jersey, Master's in Physician Assistant Studies, Medical School - University of Santo Tomas Faculty of Medicine and Surgery, Doctor of Medicine, Kings County Hospital Center, Residency in Otolaryngology, State University of New York, Downstate Medical Center, Internship in General Surgery, Long Island College Hospital, Internship in General Surgery, State University of New York, Downstate Medical Center, Residency in Otolaryngology and Head and Neck Surgery, Long Island College Hospital, Residency in Otolaryngology and Head and Neck Surgery, Columbia University, Saint Luke's-Roosevelt Hospital Center, Fellowship in Laryngology and Neurolaryngology, Medical School - Tufts University, Doctor of Medicine, West Virginia University, Residency in Otolaryngology, Mittelman Plastic Surgery, Fellowship in Facial Plastic and Reconstructive Surgery, Medical School - Tulane University, Doctor of Medicine, New York Eye and Ear Infirmary of Mount Sinai, Residency in Otolaryngology, Buckhead Facial Plastic Surgery (Fellowship), Tulane University, Masters in Public Health, St. Vincents Hospital, New York, Internship in General Surgery, American Academy of Otolaryngology Head and Neck Surgery, State University of New York, Downstate Medical Center (Residency), Pennsylvania State University, Milton S. Hershey Medical Center, Residency in Otolaryngology, Medical University of South Carolina, Fellowship in Head and Neck Oncologic and Reconstructive Surgery, Hospital of the University of Pennsylvania, Residency in Internal Medicine, American Academy of OtolaryngologyHead and Neck Surgery, Medical School - New York Medical College, Doctor of Medicine, Saint Vincent Catholic Medical Center (Internship), Manhattan Eye, Ear and Throat Hospitall, Residency in Otolaryngology, Manhattan Eye, Ear and Throat Hospital, Fellowship in Head and Neck Surgery, Manhattan Eye, Ear and Throat Hospital, Fellowship in Rhinology and Sinus Surgery, Medical School - Albert Einstein College of Medicine of Yeshiva University, Doctor of Medicine, NewYork-Presbyterian Hospital / Weill Cornell Medical Center (Fellowship), Lenox Hill Hospital, Residency in Surgery, Manhattan Eye, Ear & Throat Hospital, Residency in Otolaryngology, Wilkes University, Doctor of Nursing Practice, Medical School - University of Kentucky, Doctor of Medicine, New York Eye and Ear Infirmary of Mount Sinai, Residency in Otolaryngology and Head and Neck Surgery, Baylor All Saints Medical Center, Fellowship in Facial Plastic and Reconstructive Surgery. Rhinoplasty + Blue Cross Blue Shield Q&A. Rhinoplasty + Blue Cross Blue Shield. The intent of the surgery is to correct the deformity caused by the nasal fracture. Benefit Summary Book. Approachable and friendly. OT services emphasize useful and purposeful . Tuesday night was spent in Newark dealing with it whike attemptinf to get this Dr to send a partial to Walgreens. 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). Cosmetic: In this document, procedures are considered cosmetic when intended to change a physical appearance that would be considered within normal human anatomic variation. Zocdoc let's you see real-time availability for Blue Cross Blue Shield Ear, Nose & Throat Doctors. Examples include, but are not limited to, significant burns or other significant major facial trauma. 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. Note that services with specific coverage criteria may be reviewed retrospectively to determine if criteria are being met. On Zocdoc, you can search specifically for Blue Cross Blue Shield Ear, Nose & Throat Doctors with availability after 5 p.m. You can use Zocdoc to find Blue Cross Blue Shield Ear, Nose & Throat Doctors who are highly rated by other patients. Easy to find doctors by their professional field and those that accepts ones health coverage. Moolenburgh SE, McLennan L, Levendag PC, et al. 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. Enter the policy number without the version number (last 3 digits). Occupational Therapy (OT) is the treatment of neuromusculoskeletal and psychological dysfunction, caused by disease, trauma, congenital anomaly, or prior therapeutic process, through the use of specific tasks or goal-directed activities designed to improve functional performance of the individual. Available at: American Academy of Facial Plastic and Reconstructive Surgery, Inc. (AAFPRS). Howard BK, Rohrich RJ. Excision or shaving of the rhinophyma is considered medically necessary when both of the following criteria are met: Excision or shaving of the rhinophyma is considered cosmetic and not medically necessary when the medically necessary criteria in this section are not met. Lisa Szubin is an energetic, compassionate ear, nose, and throat doctor, who specializes in head and neck surgery in New York City. No referrals! 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{ endstream endobj 222 0 obj <. 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