Common use of Reconstructive Surgery for a Functional Deformity or Impairment Clause in Contracts

Reconstructive Surgery for a Functional Deformity or Impairment. This plan covers reconstructive surgery and procedures when the services are performed to relieve pain, or to correct or improve bodily function that is impaired as a result of:  a birth defect;  an accidental injury;  a disease; or  a previous covered surgical procedure. Functional indications for surgical correction do not include psychological, psychiatric or emotional reasons. This plan covers the procedures listed below to treat functional impairments.  abdominal wall surgery including panniculectomy (other than an abdominoplasty);  blepharoplasty and ptosis repair;  gastric bypass or gastric banding;  nasal reconstruction and septorhinoplasty;  orthognathic surgery including mandibular and maxillary osteotomy;  reduction mammoplasty;  removal of breast implants;  removal or treatment of proliferative vascular lesions and hemangiomas;  treatment of varicose veins; or  gynecomastia. Preauthorization is recommended for these services.

Reconstructive Surgery for a Functional Deformity or Impairment. This plan covers reconstructive surgery and procedures when the services are performed to relieve pain, or to correct or improve bodily function that is impaired as a result of:  • a birth defect;  • an accidental injury;  • a disease; or  • a previous covered surgical procedure. Functional indications for surgical correction do not include psychological, psychiatric or emotional reasons. This plan covers the procedures listed below to treat functional impairments.  • abdominal wall surgery including panniculectomy (other than an abdominoplasty);  • blepharoplasty and ptosis repair;  • gastric bypass or gastric banding;  • nasal reconstruction and septorhinoplasty;  • orthognathic surgery including mandibular and maxillary osteotomy;  • reduction mammoplasty;  • removal of breast implants;  • removal or treatment of proliferative vascular lesions and hemangiomas;  • treatment of varicose veins; or  • gynecomastia. Preauthorization is recommended for these services.

Reconstructive Surgery for a Functional Deformity or Impairment. This plan covers reconstructive surgery and procedures when the services are performed to relieve pain, or to correct or improve bodily function that is impaired as a result of:  • a birth defect;  • an accidental injury;  • a disease; or  • a previous covered surgical procedure. Functional indications for surgical correction do not include psychological, psychiatric or emotional reasons. This plan covers the procedures listed below to treat functional impairments.  • abdominal wall surgery including panniculectomy (other than an abdominoplasty);  • blepharoplasty and ptosis repair;  • gastric bypass or gastric banding;  • nasal reconstruction and septorhinoplasty;  • orthognathic surgery including mandibular and maxillary osteotomy;  • reduction mammoplasty;  • removal of breast implants;  • removal or treatment of proliferative vascular lesions and hemangiomas;  • treatment of varicose veins; or  • gynecomastia. Preauthorization is recommended may be required for these services.

Reconstructive Surgery for a Functional Deformity or Impairment. This plan covers reconstructive surgery and procedures when the services are performed to relieve pain, or to correct or improve bodily function that is impaired as a result of:  • a birth defect;  • an accidental injury;  • a disease; or  • a previous covered surgical procedure. Functional indications for surgical correction do not include psychological, psychiatric or emotional reasons. This plan covers the procedures listed below to treat functional impairments.  abdominal • Abdominal wall surgery including panniculectomy Panniculectomy (other than an abdominoplasty);  blepharoplasty • Blepharoplasty and ptosis repairPtosis Repair;  gastric bypass • Gastric Bypass or gastric bandingGastric Banding;  nasal reconstruction • Nasal Reconstruction and septorhinoplastySeptorhinoplasty;  orthognathic • Orthognathic surgery including mandibular Mandibular and maxillary osteotomyMaxillary Osteotomy;  reduction mammoplasty• Reduction Mammoplasty;  removal • Removal of breast implantsBreast Implants;  removal • Removal or treatment Treatment of proliferative vascular lesions Proliferative Vascular Lesions and hemangiomasHemangiomas;  treatment • Treatment of varicose veinsVaricose Veins; or  gynecomastia• Gynecomastia. Preauthorization is recommended for these services.

Reconstructive Surgery for a Functional Deformity or Impairment. This plan covers reconstructive surgery and procedures when the services are performed to relieve pain, or to correct or improve bodily function that is impaired as a result of:  a birth defect;  an accidental injury;  a disease; or  a previous covered surgical procedure. Functional indications for surgical correction do not include psychological, psychiatric or emotional reasons. This plan covers the procedures listed below to treat functional impairments.  abdominal wall surgery including panniculectomy (other than an abdominoplasty);  blepharoplasty and ptosis repair;  gastric bypass or gastric banding;  nasal reconstruction and septorhinoplasty;  orthognathic surgery including mandibular and maxillary osteotomy;  reduction mammoplasty;  removal of breast implants;  removal or treatment of proliferative vascular lesions and hemangiomas;  treatment of varicose veins; or  gynecomastia. Preauthorization is recommended may be required for these services.

Reconstructive Surgery for a Functional Deformity or Impairment. This plan covers reconstructive surgery and procedures when the services are performed to relieve pain, or to correct or improve bodily function that is impaired as a result of:  a birth defect;  an accidental injury;  a disease; or  a previous covered surgical procedure. Functional indications for surgical correction do not include psychological, psychiatric or emotional reasons. This plan covers the procedures listed below to treat functional impairments.  abdominal Abdominal wall surgery including panniculectomy Panniculectomy (other than an abdominoplasty);  blepharoplasty Blepharoplasty and ptosis repairPtosis Repair;  gastric bypass Gastric Bypass or gastric bandingGastric Banding;  nasal reconstruction Nasal Reconstruction and septorhinoplastySeptorhinoplasty;  orthognathic Orthognathic surgery including mandibular Mandibular and maxillary osteotomyMaxillary Osteotomy;  reduction mammoplastyReduction Mammoplasty;  removal Removal of breast implantsBreast Implants;  removal Removal or treatment Treatment of proliferative vascular lesions Proliferative Vascular Lesions and hemangiomasHemangiomas;  treatment Treatment of varicose veinsVaricose Veins; or  gynecomastiaGynecomastia. Preauthorization is recommended for these services.