Transcription of Cosmetic and Reconstructive Services and Procedures
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Cosmetic and Reconstructive Services and Procedures
Cosmetic and Reconstructive Services and Procedures Page 1 of 17 UnitedHealthcare Medicare Advantage Policy Guideline Approved 07/14/2021 Proprietary Information of UnitedHealthcare. Copyright 2021 United HealthCare Services , Inc. UnitedHealthcare Medicare Advantage Policy Guideline Cosmetic and Reconstructive Services and Procedures Guideline Number: Approval Date: July 14, 2021 Terms and Conditions Table of Contents Page Policy Summary .. 1 Applicable Codes .. 5 Definitions .. 11 Questions and Answers .. 13 References .. 13 Guideline History/Revision Information .. 16 Purpose .. 16 Terms and Conditions .. 16 Policy Summary See Purpose Overview The purpose of this policy is to clarify coverage of Cosmetic vs. Reconstructive surgical Procedures . Section 1862(a) (1) (A) of Title XVIII of the Social Security Act provides in part that "..no payment may be made under Part A or B (of Medicare) for any expenses incurred for items or Services not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.
Guidelines According to the American Society of Plastic and Reconstructive Surgeons, the specialty of plastic surgery includes cosmetic and reconstructive procedures: • Cosmetic surgery is performed to reshape normal structures of the body in order to improve the patient's appearance and self-esteem.
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