http://cosmeticfacesurgery.org/1181/when-is-otoplasty-considered-reconstructive-vs-cosmetic/ Cosmetic Face Surgery - The complete Guide Thu, 12 Aug 2010 23:10:12 -0500 hourly 1 http://wordpress.org/?v=3.0.4 http://cosmeticfacesurgery.org/1181/when-is-otoplasty-considered-reconstructive-vs-cosmetic/comment-page-1/#comment-2531 peaceablefruit206 Tue, 16 Mar 2010 23:26:09 +0000 http://cosmeticfacesurgery.org/1181/when-is-otoplasty-considered-reconstructive-vs-cosmetic/#comment-2531 For an insurance company to cover this type of surgery, the diagnoses must not only be congenital, but it must also be an anomaly, meaning that it is a problem. The diagnoses codes on the claim form submitted by your surgeon's office must be medical codes, not cosmetic codes, and the medical records (which I'm sure your insurance company will request upon receipt of the claim) must back that up. It is important that the medical records also show that the surgery was done for medical and not for cosmetic reasons, because even if the diagnoses code on the claim says that it was done for a medical reason, the insurance company can still deny the claim saying that it is cosmetic if the medical records show that the surgery was not medically necessary. For an insurance company to cover this type of surgery, the diagnoses must not only be congenital, but it must also be an anomaly, meaning that it is a problem. The diagnoses codes on the claim form submitted by your surgeon’s office must be medical codes, not cosmetic codes, and the medical records (which I’m sure your insurance company will request upon receipt of the claim) must back that up. It is important that the medical records also show that the surgery was done for medical and not for cosmetic reasons, because even if the diagnoses code on the claim says that it was done for a medical reason, the insurance company can still deny the claim saying that it is cosmetic if the medical records show that the surgery was not medically necessary.

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