On average, patients who use Zocdoc can search for an Ear, Nose & Throat Doctor who takes Blue Cross Blue Shield insurance, book an appointment, and see the Ear, Nose & Throat Doctor within 24 hours. Charalampaki P, Kafadar AM, Grunert P, et al. Transfers, anastomosis or other procedures of the facial nerve or other cranial nerves or their branches are considered not medically necessary when the medically necessary or reconstructive criteria in this section are not met. ", "Great physician. Arch Facial Plast Surg. Most insurers provide coverage for video visits at the same cost as in-person visits. Le Fort III distraction osteogenesis versus conventional Le Fort III osteotomy in correction of syndromic midfacial hypoplasia: a systematic review. "Straightforward. Levin is fluent in Spanish. Just choose your carrier and plan from the drop-down menu at the top of the page. Eligible for Medi-Cal Get the care you need with Blue Shield of California Promise Health Plan. By continuing to use this website, you consent to these cookies. Facial Plast Surg Clin North Am. This area may also be referred to as a double chin. IV-73 Rhinoplasty and Septorhinoplasty No New Commercial . A NOTE was added after the Reconstructive definition to clarify that not all benefit contracts include a reconstructive services benefit. Every time a patient completes an appointment booked on Zocdoc, theyre invited to review their experience. Originally from New York, Dr. Szubin graduated Harvard College with a degree in biochemistry. For more information, view our privacy policy. Clarified and reformatted Position Statements. Covered benefits. Since 1933, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has helped millions of North Carolinians get and stay healthy. That means your surgeon is unlikely to do everything the patient wants for the insurance payment. Learn more. Our medical policies help us determine what technology, procedure, treatment, supply, equipment, drug, or . 1996-Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. Concepts of Medical Necessity, Reconstructive and Cosmetic. I love that you can find immediate appointments to different physicians including some specialists in certain fields. Under Basic Option, benefits are not available for services performed by Non-preferred providers, except in certain situations such as emergency care. CPT Codes. Septoplasty is generally performed to improve nasal breathing, and for this reason it is typically covered by most insurance plans. In addition, face lifts are used to create a more youthful appearance in individuals concerned with changes due to the aging process. ", "I made an appointement on Thursday November 17th. Constantine KK, Gilmore J, Lee K, Leach J Jr. Rhytidectomy is considered reconstructive when intended to address a significant variation from normal related to accidental injury, disease, trauma, treatment of a disease or congenital defect. NOTE: Not all benefit contracts/certificates include benefits for reconstructive services as defined by this document. Dr. Lessow's ENT trained physician assistant Rian Rosen PA-C works together with Dr. Lessow and independently to evaluate and treat all general ENT issues. Medical technology is constantly evolving, and we reserve the right to review and update Medical Policy periodically. Otolaryngol Clin North Am. Otolaryngol Head Neck Surg. 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. Title: Microsoft Word - 2019 Cosmetic Services . This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jersey's Health Insurance Marketplace. hWn8>6(\N Approachable and friendly. 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. endstream endobj 222 0 obj <. Dental diagnostic and preventive services. Saltaji H, Altalibi M, Major MP, et al. If you are in distress please go to the nearest ER or call 911. 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. Friday and thru thanksgiving doesn't cut it. Rhinoseptoplasty: A surgical procedure, also referred to as a septorhinoplasty, performed on the nose and the nasal septum (cartilage and bony structure that separates the two nostrils). 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. I highly recommend him to my friends and you!". stream "as always she provided my mom with the best of care". Examples include, but are not limited to, repair of ear lobes with clefts or other consequences of ear piercing, or protruding ears. Dr. Lam has been involved in research throughout his academic career. Removed term physical from the term physical functional impairment in the Facial Plastic Surgery, Otoplasty, Rhinophyma, Rhinoplasty or Rhinoseptoplasty and Cranial Nerve Procedures position statements. 2006; 39(3):475-492, viii. 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. Benefit Summary Book. 2023 Plan documents. 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. Kim JH, Lee JW, Park CH. Treatment of nasal obstruction in the posttraumatic nose. The online Medical Policy Reference Manual contains approved medical policies and operating procedures for all products offered by CareFirst. Policies are intended to be used for some or all of the following purposes in Blue Cross and Blue Shield's administration of plans: (i) adjudication of claims (including pre-admission certification, pre-determinations and pre-procedure . K143173. These guidelines are the proprietary information of Blue Cross and Blue Shield of Minnesota. It is not intended as, and Zocdoc does not provide, medical advice, diagnosis or treatment. Reconstructive: In this document, procedures are considered reconstructive when intended to address a significant variation from normal related to accidental injury, disease, trauma, treatment of a disease or congenital defect. No go. Updated References. Plast Reconstr Surg. Do surgeons think it's unethical to reshape it to my preference under insurance? Facial Plast Surg. She is affiliated with New York University Langone Medical Center, Northwell Health -- Lenox Hill Hospital and Hackensack University Medical Center. Transfers, anastomosis or other procedures of the facial nerve or other cranial nerves or their branches are considered medically necessary to correct a significant functional impairment and the procedure can be reasonably expected to improve the functional impairment. Corey CL, Most SP. She explains diagnoses and treatment plans carefully, so that patients can be part of their healing process. Dr. Burnett practices the full breadth of otolaryngology, specializing in disorders of the sinuses and sinus surgery, disorders of the throat, ears and head and neck. 18 0 obj <> endobj Blue Cross & Blue Shield of Nebraska offers a variety of health, dental & travel insurance plans for groups, individuals and families at an affordable rate. We work with thousands of doctors, specialists, and hospitals throughout North Carolina, and we partner with many local organizations to help you get the care and services you need to . Use Zocdoc to find ear, nose & throat doctors near you who take Blue Cross Blue Shield insurance. endobj Minor format and spacing changes. Rhinoplasty with Nasal Reconstruction, Preauthorization via the Web-Based Tool for Procedures . D. Rhinoplasty or RhinoseptoplastyWhen services may be Medically Necessary or Reconstructive when criteria are met: Rhinoplasty, primary [includes codes 30400, 30410, 30420], Rhinoplasty, secondary [includes codes 30430, 30435, 30450], Supplement nose with autologous tissue substitute [by approach; includes codes 09UK07Z, 09UKX7Z], Supplement nose with synthetic substitute [by approach; includes codes 09UK0JZ, 09UKXJZ], Supplement nose with nonautologous tissue substitute [by approach; includes codes 09UK0KZ, 09UKXKZ], Supplement nasal bone with autologous tissue substitute, open approach, Supplement nasal bone with synthetic substitute, open approach, Supplement nasal bone with nonautologous tissue substitute, open approach, Alteration of nose with autologous tissue substitute [by approach; includes codes 090K07Z, 090K37Z, 090K47Z, 090KX7Z], Alteration of nose with synthetic substitute [by approach; includes codes 090K0JZ, 090K3JZ, 090K4JZ, 090KXJZ], Alteration of nose with nonautologous tissue substitute [by approach; includes codes 090K0KZ, 090K3KZ, 090K4KZ, 090KXKZ], Alteration of nose [by approach; includes codes 090K0ZZ, 090K3ZZ, 090K4ZZ, 090KXZZ]. As a Horizon NJ Health member, you don't need referrals for in-network specialists and have no or low copays for: Primary care office visits and preventive services. Been able to utilize my Membership and get my questions answered regularly.". 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. x][o6~ "^t+IYtf }h-yee_PFIlZ[}>eil4{gj*IE6EU^>7x?w?go|OBxF'7(/P' Enx~x_&ds:{c7EOPUn2B}/{'Bh;*-vDr-`9GH.np?_zG"M^Y!NNlA@D CU9MIkW2jygThHjA`A5Ay4H^zWfqPv8S=E#f0>|:Z7-T@"r]M^6:CF3^.(j1XM.nWiwwmOQ}7)G+~BP5`+dxP4U4\4,fE0hK0bTxiL8>m^xHk$M?af,[ ,v8Ph@ Rhinoplasty is consideredCOSMETIC for all other indications. D. Rhinoplasty or Rhinoseptoplasty (procedure which combines both rhinoplasty and septoplasty) . E. Rhytidectomy (face lift)When services may be Reconstructive when criteria are met: Extraction of scalp subcutaneous tissue and fascia, open approach, Extraction of scalp subcutaneous tissue and fascia, percutaneous approach, Extraction of face subcutaneous tissue and fascia, open approach, Extraction of face subcutaneous tissue and fascia, percutaneous approach, Alteration of face subcutaneous tissue and fascia, open approach, Alteration of face subcutaneous tissue and fascia, percutaneous approach, Alteration of face, percutaneous approach. 2010; 65(6):528-534. I am a member of the Bronx County Medical Society. 221 0 obj <> endobj No. Coverage Information. He treats many conditions, both cosmetic and complex, that affect the head, neck, and entire facial area. 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. Dr. Szubin is also using new drug-eluting stents during sinus surgery, which is beneficial and cutting-edge. Before making a final decision, please read the Plans federal brochure (RI 71-005). % With three benefit plans to choose from, you can get the coverage that fits your needs and budget. 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. Stucker FJ, Lian T, Sanders K. Management of severe bilateral nasal wall collapse. Newark fixed it. Learn more about our other insurance plans and Medicare plans, or contact a sales . I was in and out which is how I like my doctor visits!". Also document that the beak have caused the deformity and that the surgery is to correct the deformity as a result of the trauma. Otolaryngol Head Neck Surg. Blue Shield of California 601 12 th Street, Oakland, CA 94607 . American Physical Therapy Association (APTA). One must understand that insurance companies do not reimburse enough to cover the cost of a cosmetic rhinoplasty. She spent a summer at the University of Colorado School of Medicine as a member of the Emergency and Wilderness Medicine Program. No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, electronic, mechanical, photocopying, or otherwise, without permission from the health plan. Customer value is our cornerstone. Forms can be sent to you to fill out at home. Inclusion or exclusion of a code does not constitute or imply member coverage or provider reimbursement. MPTAC review. J Oral Maxillofac Surg. Medical policies are based on proven merits and credible scientific evidence. We recommend you check with your insurance carrier directly to confirm your coverage and out of pocket costs for video visits. Updated formatting in Position Statement section. Following this residency, Dr. Reitzen completed a specialized and dedicated facial plastic and reconstructive surgery fellowship program at the prestigious University of Miami Health System. Benefit plans vary in coverage and some plans may not provide coverage for certain services addressed in the medical policies. 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. 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