Orthognathic Surgery

by  Wyn Staheli
December 28th, 2017

Orthognathic surgery is corrective jaw surgery, which payers classify as either medically necessary or aesthetic (not medically necessary). With most payers, surgery performed to correct functional impairments, after conservative measures have failed, would be considered medically necessary.

Conditions considered medically necessary for this surgery may include:

Note: Always check individual payer policies to identify the specific criteria that must be met for the diagnosis to qualify as medically necessary for orthognathic surgery, as each payer policy may slightly differ from the other.

TIP: Orthognathic surgery for temporomandibular joint pathology, pain, or dysfunction is generally considered experimental/investigational and therefore excluded from coverage. There may be exceptions to this so be sure to verify specific payer policies.

Orthognathic Surgery. (2017, December 28). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/orthognathic-surgery-32770.html

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