Allan Levin was a chief resident in Ear Nose & Throat at Mount Sinai Hospital, one of the foremost training There may also be thick bumps on the lower half of the nose and the nearby cheek areas. I. Rhinoplasty may be considered MEDICALLY NECESSARY AND APPROPRIATEwhen ANY of the following criteria are met: II. Rhinoseptoplasty, involving both rhinoplasty and septoplasty, is a more extensive surgical procedure combining repairs to the external nasal pyramid or skeleton with repairs of the nasal septa to correct a functional impairment involving both structures. $15copay all additional visits, Inpatient (Precertification is required): $250per day copay; up to $1,500per admission, Earn $50 for completing the Blue Health Assessment3. Revision of Position Statement for reconstructive rhinoplasty for nasal fractures. Do surgeons think it's unethical to reshape it to my preference under insurance? We would be happy to help you with any of the following conditions: allergy and sinus disorders, hearing loss, dizziness and balance disorders, ear and throat infection, swallowing difficulties, voice problems, snoring and sleep apnea, and head and neck masses. Dr. Burnett trained at the New York University School of Medicine. endobj 0 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!". endobj 2010; 143(1):48-59. MPTAC review. The protection of your privacy will be governed by the privacy policy of that site. Removed ICD-9 codes from Coding section. Dr. Levin values the time he spends with patients, They offer health plans that can be customized for individuals, children, and families that include consumer-directed plans, Health Savings Accounts, and . One must understand that insurance companies do not reimburse enough to cover the cost of a cosmetic rhinoplasty. 2023 Plan documents. His topical intranasal solution medications are 500 EXCHANGE STREET, PROVIDENCE, RI 02903-2699 MEDICAL COVERAGE POLICY | 1 (401) 274-4848 WWW.BCBSRI.COM . Any sale, copying or dissemination of the medical policies is prohibited; however, limited copying of medical policies is permitted for individual use. Please refer to the member's contract benefits in effect at the time of service to determine coverage or non-coverage as it applies to an individual member. Under Basic Option, benefits are not available for services performed by Non-preferred providers, except in certain situations such as emergency care. 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. OT services emphasize useful and purposeful . endstream endobj startxref Understanding the nasal airway: principles and practice. Everything went smoothly. In addition, face lifts are used to create a more youthful appearance in individuals concerned with changes due to the aging process. endobj Check Eligibility. Forms can be sent to you to fill out at home. Our patients find that the first week has the most discomfort after septoplasty only because of packing with stents to keep the airway open and keep things stable while you're healing. We recommend you check with your insurance carrier directly to confirm your coverage and out of pocket costs for video visits. In these situations you may only have to pay simply a co . Please call by Friday 5pm for Monday cancellations. 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. 2000; 38(2):72-78. Other procedures are not done to correct a functional impairment. Our Patient Advocate Center hours are are Monday-Thursday 8 a.m.- 7 p.m., Friday 8 a.m.-5 p.m. and Saturday 8 a.m.- 12 p.m.. Nothing for covered preventive screenings, immunizations and services, In-network care only, except in certain situations like emergency care. You will have your temperature taken at the door before you enter. Dr. Mourad received advanced surgical training at respected institutions including New Yorks Beth Israel Medical Center and New York Eye and Ear Infirmary of Mount Sinai, where he was chief resident in otolaryngology in the specialty of head and neck surgery. No referrals! A structural abnormality displaces the nasal structure, resulting in fixed, medically significant airway obstruction that medical therapy has failed to correct; Performed on an eligible dependent child who has a congenital disease or anomaly that has caused a functional defect (e.g. Provided clarification of Position Statement for when otoplasty is considered reconstructive. %%EOF Facial plastic surgery is considered cosmetic and not medically necessary when intended to change a physical appearance that would be considered within normal human anatomic variation. Gx@_jQtmE- `9tCt_ISzxx JEV7tP4. 2014; 43(3):286-295. Before making a final decision, please read the Plan's federal brochure (RI 71-005). Blue Shield of California 601 12 th Street, Oakland, CA 94607 . Alloplastic devices are less invasive and can be used in situations where costal harvesting cannot be performed, but they are associated with a higher rate of extrusion and infection (Siegert, 2019). K152463. Mehta RP. Rhinoplasty may be performed to alter the shape of the nose to improve the passage of air while breathing (from blocked nasal passages or severe nasal obstruction), or to correct structural damage due to disease or trauma (for example, to repair a nasal fracture) without involvement of the underlying nasal septa. I operate at New York Eye and Ear Infirmary and my office is conveniently located on the South side of Union Square. He listened to my concerns and tried to address it.". Since 1933, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has helped millions of North Carolinians get and stay healthy. Updated References section. Outside the United States. Plast Reconstr Surg. Zocdoc lets you search specifically for an Ear, Nose & Throat Doctor who has appointments available before 10:00 am, or after 5:00 pm. Find Blue Cross Blue Shield Plastic Surgeons & Providers with verified reviews. Dr. Lam philosophy of striving to give patients a natural, non-surgical look. The use of specific product names is illustrative only. HiColumbia6571, The operating room, anesthesia, and surgeons fees are each billed separately for both cosmetic to the patient and reconstructive procedures to the insurance company. 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. Dr. Burnett is a member of American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Board of Internal Medicine, and the American Medical Association. In addition to the active and pending Medical Policies, BCBSIL has included policies which are under development or being revised. In addition I also diagnose and treat allergies., snoring and sleep apnea , dizziness and balance disturbances ,sleep disorder. 3 0 obj 2002; 109(3):1128-1134. 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