Cigna prior authorization for 15774*: Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; each additional 25 cc injectate, or part thereof
Code
15774*
Description
Grafting of autologous fat harvested by liposuction technique to face,
eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; each
additional 25 cc injectate, or part thereof
Source
Master Precertification List
For Health Care Providers, Pg 19 Original policy
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