QUEST Integration – Cosmetic Procedures – Claim Documentation Requirements

Original Effective Date:

12/01/2010

Current Effective Date:

06/01/2015

When submitting claims for one of the following HCPCS or CPT procedure codes, please submit an operative report or other documentation with the claim. See Cosmetic and Reconstructive Surgery and Services for more information.

Note: The list below is not an exhaustive list of all possible procedures that may be considered cosmetic. If you are planning to perform a procedure that you believe may be considered cosmetic, please call HMSA at 808-948-6464 on Oahu to confirm whether the procedure may be considered cosmetic.

CPT or HCPCS Code Description
11920 Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.0 sq cm or less
11921 6.1 to 20.0 sq cm
11922 each additional 20.0 sq cm
11960 Insertion of tissue expander(s) for other than breast, including subsequent expansion
11970 Replacement of tissue expander with permanent prosthesis
11971 Removal of tissue expander(s) without insertion of prosthesis
15750 Flap; neurovascular pedicle
15775 Punch graft for hair transplant; 1 to 15 punch grafts
15776 more than 15 punch grafts
15760 Graft; composite (e.g., full thickness of ear or nasal ala), including primary closure; donor area
15770 derma-fat fascia
15786 Abrasion; single lesion (e.g., keratosis, scar)
15787* each additional four lesions or less
15819 Cervicoplasty
15820 Blepharoplasty, lower eyelid;
15821 with extensive herniated fat pad
15822 Blepharoplasty, upper eyelid;
15823 with excessive skin weighting down lid
15830 Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy
15847 Excision, excessive skin and subcutaneous tissue (includes lipectomy), abdomen (e.g., abdominoplasty) (includes umbilical transposition and fascial plication) (List separately in addition to code for primary procedure)
15879 Suction assisted lipectomy; lower extremity
19300 Mastectomy for gynecomastia
19316 Mastopexy
19324 Mammoplasty, augmentation; without prosthetic implant
19325 with prosthetic implant
19328 Removal of intact mammary implant
19330 Removal of mammary implant material
19340 Immediate insertion of breast prosthesis following mastopexy, mastectomy or in reconstruction
19342 Delayed insertion of breast prosthesis following mastopexy, mastectomy or in reconstruction
19350 Nipple/areola reconstruction
19355 Correction of inverted nipples
19357 Breast reconstruction, immediate or delayed with tissue expander, including subsequent expansion
19361 Breast reconstruction with latissimus dorsi flap, with or without prosthetic implant
19364 Breast reconstruction with free flap
19366 Breast reconstruction with other technique
19367 Breast reconstruction with transverse rectus abdominis myocutaneous flap (TRAM), single pedicle, including closure of donor site;
19368 with microvascular anastomosis (supercharging)
19369 Breast reconstruction with transverse rectus abdominis myocutaneous flap (TRAM), double pedicle, including closure of donor site
19370 Open periprosthetic capsulotomy, breast
19371 Periprosthetic capsulectomy, breast
19380 Revision of reconstructed breast
19396 Preparation of moulage for custom breast implant
20912 Cartilage graft; nasal septum
21120 Genioplasty; augmentation (autograft, allograft, prosthetic material)
21121 sliding osteotomy, single piece
21122 sliding osteotomies, two or more osteotomies (e.g., wedge excision or bone wedge reversal for asymmetrical chin)
21123 sliding, augmentation with interpositional bone grafts (including obtaining autografts)
21125 Augmentation, mandibular body or angle; prosthetic material
21127 with bone graft, onlay or interpositional (includes obtaining autograft)
21137 Reduction, forehead; contouring only
21138 contouring and application of prosthetic material or bone graft (includes obtaining autograft)
21139 contouring and set back of anterior frontal sinus wall
21141 Reconstruction midface, LeFort I; single piece, segment movement in any direction (e.g., for Long Face Syndrome), without bone graft
21142 two pieces, segment movement in any direction, without bone graft
21143 three or more pieces, segment movement in any direction, without bone graft
21145 single piece, segment movement in any direction, requiring bone grafts (includes obtaining autografts)
21146 two pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (e.g., ungrafted unilateral alveolar cleft)
21147 three or more pieces, segment movement in any direction requiring bone grafts (includes obtaining autografts) (e.g., ungrafted bilateral alveolar cleft or multiple osteotomies)
21150 Reconstruction midface, LeFort II; anterior intrusion (e.g., Treacher-Collins Syndrome)
21151 any direction, requiring bone grafts (includes obtaining autografts)
21154 Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining autografts); without LeFort I
21155 with LeFort I
21159 Reconstruction midface, LeFort III (extra and intra-cranial) with forehead advancement (e.g., mono bloc), requiring bone grafts (includes obtaining autografts); without LeFort I
21160 with LeFort I
21172 Reconstruction superior-lateral orbital rim and lower forehead, advancement or alteration, with or without grafts (includes obtaining autografts)
21175 Reconstruction, bifrontal, superior-lateral orbital rims and lower forehead, advancement or alteration (e.g., plagiocephaly, trigonocephaly, brachycephaly), with or without grafts (includes obtaining autografts)
21179 Reconstruction, entire or majority of forehead and/or supraorbital rims; with grafts (allograft or prosthetic material)
21180 with autograft (includes obtaining grafts)
21188 Reconstruction midface, osteotomies (other than LeFort type) and bone grafts (includes obtaining autografts)
21193 Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; without bone graft
21194 with bone graft (includes obtaining graft)
21195 Reconstruction of mandibular rami and/or body, sagittal split; without internal rigid fixation
21196 with internal rigid fixation
21198 Osteotomy, mandible, segmental;
21199 with genioglossus advancement
21206 Osteotomy, maxilla, segmental (e.g., Wassmund or Schuchard)
21208 Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant)
21210 Graft, bone; nasal maxillary or malar areas (includes obtaining graft)
21215 mandible (includes obtaining graft)
21230 Graft, rib cartilage, autogenous, to face, chin, nose or ear (includes obtaining graft)
21235 ear cartilage, autogenous, to nose or ear (includes obtaining graft)
21244 Reconstruction of mandible, extraoral, with transosteal bone plate (e.g., mandibular staple bone plate)
21245 Reconstruction of mandible or maxilla, subperiosteal implant; partial
21246 complete
21247 Reconstruction of mandibular condyle with bone and cartilage autografts (includes obtaining grafts) (e.g., for hemifacial microsomia)
21248 Reconstruction of mandible or maxilla, endosteal implant (e.g., blade, cylinder); partial
21249 complete
21255 Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (includes obtaining autografts)
21270 Malar augmentation prosthetic material
21275 Secondary revision of orbitocraniofacial reconstruction
21280 Medial canthopexy (separate procedure)
21282 Lateral canthopexy
21740 Reconstructive repair of pectus excavatum or carinatum
30150 Rhinectomy; partial
30160 total
30400 Rhinoplasty; primary; lateral and alar cartilages and/or elevation of nasal tip
30410 complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip
30420 including major septal repair
30430 Rhinoplasty, secondary; minor revision (small amount of nasal tip work)
30435 intermediate revision (bony work with osteotomies)
30450 major revision (nasal tip work and osteotomies)
30620 Septal or other intranasal dermatoplasty (does not include obtaining graft)
36468 Single or multiple injections of sclerosing solutions, spider veins (telangiectasia); limb or trunk
36469 face
36470 Injection of sclerosing solution; single vein
36471 multiple veins, same leg
37788 Penile revascularization, artery, with or without vein graft
37790 Penile venous occlusive procedure
40820 Destruction of lesion or scar of vestibule of mouth by physical methods (e.g., laser, thermal, cryo, chemical)
41510 Suture of tongue to lip for micrognathia (Douglas type procedure)
67900 Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)
67901 Repair of blepharoptosis; frontalis muscle technique with suture or other material
67902 frontalis muscle technique with fascial sling (includes obtaining fascia)
67903 (tarso) levator resection or advancement, internal approach
67904 (tarso) levator resection or advancement external approach
67906 superior rectus technique with fascial sling (includes obtaining fascia)
67908 conjunctivo-tarso-Muller's muscle-levator resection (e.g., Fasanella-Servat type)
67909 Reduction of overcorrection of ptosis
67911 Correction of lid retraction
69300 Otoplasty, protruding ear, with or without size reduction
96405 Chemotherapy administration, intralesional; up to and including 7 lesions
96406 more than 7 lesions
HCPCS Code Description
C1789 Prosthesis, breast (Implantable)
L8600 Implantable breast prosthesis, silicone or equal
S0196 Injectable poly-l-lactic acid, restorative, implant, 1 ml, face (deep dermis, subcutaneous layers)

Revision History

Date Nature of Revision
08/03/2026 Migrated to new platform.