About this policy
CMS National Coverage Determination | ncd_id=14 | manual_section=140.4 | coverage_level_code=3 | national_coverage_type=True | under_review=False | lab_ncd=False
Coverage indications
The cosmetic surgery exclusion precludes payment for any surgical procedure directed at improving appearance. The condition giving rise to the patient's preoperative appearance is generally not a consideration. The only exception to the exclusion is surgery for the prompt repair of an accidental injury or for the improvement of a malformed body member which coincidentally serves some cosmetic purpose. Since surgery to correct a condition of "moon face" which developed as a side effect of cortisone therapy does not meet the exception to the exclusion, it is not covered under Medicare (§1862(a)(10) of the Act).
Documentation requirements
Cross Reference: See the Medicare Benefit Policy Manual , Chapter 16, §120. Revision History: 5/1989 - Added statutory authority citation. Effective date NA. (TN 36) Benefit Categories: 0 - No Benefit Category Transmittal: transmittal_number=36 | transmittal_issue_date=1989-05-01
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
Backwork has no codes on record for this policy. Check the source.