Cosmetic and Reconstructive Procedures – Medicare Advantage Medical Policy
Medicare Advantage medical policy clarifying coverage distinctions between cosmetic and reconstructive surgical procedures, listing procedure-specific coverage rationales, applicable CMS LCD/LCA references, and CPT/HCPCS codes that may be cosmetic or reconstructive or are considered cosmetic (not covered).
Added language that Medicare does not have an NCD for rib graft and that LCDs/LCAs must be followed where applicable.
Removed CPT code 15819 from Cosmetic and Non-Covered codes.
Added multiple ICD-10 diagnosis codes for Abdominal Lipectomy/Panniculectomy (L98.431-L98.439) and facial/maxillofacial reconstruction (H05.831-H05.833).
Updated supporting information sections (Clinical Evidence, FDA, References) to reflect current information.
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