Cosmetic vs Reconstructive Surgery for Cleft Palate: A Window Into the Medical Necessity Debate

Medical necessity is a legal term used in most commercial health plan contracts to establish which interventions a health plan will cover for its members. At the same time, physicians think of medical necessity as the criterion by which they judge an intervention to be appropriate. Singer and Bergth...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2001-11, Vol.286 (17), p.2162-2162
Main Authors: Singer, Sara, Bergthold, Linda
Format: Article
Language:English
Subjects:
Health insurance
Medical procedures
Plastic surgery
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Summary:Medical necessity is a legal term used in most commercial health plan contracts to establish which interventions a health plan will cover for its members. At the same time, physicians think of medical necessity as the criterion by which they judge an intervention to be appropriate. Singer and Bergthold discuss plastic surgery for a cleft palate, and the debate over whether the surgery is cosmetic or reconstructive.
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.286.17.2162-JMS1107-6-1