(c) “Reconstructive surgery” means surgery performed on abnormal structures of the body caused by congenital defects, developmental abnormalities, trauma, infection, tumors, or disease to do either of the following:

1. (1) To improve function.
2. (2) To create a normal appearance, to the extent possible.

(e) In connection with the interpretation of the definition of reconstructive surgery, a proposed surgical procedure may be subject to prior authorization and utilization review that may include, but need not be limited to, denial under any of the following circumstances:

1. (1) There is another more appropriate surgical procedure that will be approved for the enrollee.
2. (2) The procedure or procedures offer only a minimal improvement in the appearance of the enrollee, as defined in regulations adopted by the department.
3. (3) Denial of payment for procedures performed without prior authorization.