CPT 21198, in plain terms, covers Surgical procedure to rebuild or restore a section of the lower jawbone that's been damaged or removed. CPT 21198 is referenced in 2 tracked payer policy changes from Blue Cross Blue Shield of Rhode Island and Humana. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 21198 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
Official descriptor: CPT 21198 on AAPC
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