Maxillary Two-Piece Osteotomy and Maxillary Segmental Osteotomy at Same Time?

[sanddunes]

I hope somebody can help me with this. 

I am trying to figure out if it is possible to be having a Maxillary Two-Piece Osteotomy and Maxillary Segmental Osteotomy at the same time.  They sound like the same procedure to me?  If they are pretty much the same procedure then it would make sense why the insurance would not approve them both.

Did the Doctor make a mistake submitting the codes? 

My doctor requested pre-authorization for:

21206 - Osteotomy, maxilla, segmental (denied)
21142 - Maxillary, two-piece osteotomy (approved)
21196 - Mandibular Osteotomy  with internal rigid fixation (approved).

[Tiny]

No ideal about the codes but are you having a subapical segmental osteotomy? Around which teeth?

[sanddunes]

No ideal about the codes but are you having a subapical segmental osteotomy? Around which teeth?

No, I don't think so...  I was told that my upper jaw is being brought forward 5mm and widened (which I assumed is what the two-piece maxillary osteotomy is for) and the lower jaw is being brought forward 7.1mm with rotation, along with 1mm impaction.  I am just not sure what the segmental maxillary osteotomy is for and how that is any different than the two piece maxillary osteotomy.

[x]

call your insurance and ask

[Tiny]

I am just not sure what the segmental maxillary osteotomy is for and how that is any different than the two piece maxillary osteotomy.

Ask your doctor?  It's a bit confusing

[sanddunes]

call your insurance and ask

The Aetna reps I talk to on the phone can barely even pronounce "maxillary osteotomy" and have no idea what any of the procedures are.  They just tell me which ones were approved and denied.  I asked to speak to a nurse or doctor about it and they said the nurses and doctors only talk directly to the doctor who submitted the claim or the insurance rep at the doctors office