31238 Insurance Policy Changes

Devices for Post-Operative Use Following Endoscopic Sinus Surgery (CPB 0840, reviewed 2025-12-04)

Aetna's updated Clinical Policy Bulletin 0840 (effective 2025-12-04) clarifies that specific sinus devices for post-operative use following endoscopic sinus surgery—including BISORB, Propel, Relieva Stratus MicroFlow spacer, Sinu-Foam spacer, and drug-loaded hemostatic sponges—are considered experimental, investigational, or unproven and are NOT covered. Resorbable steroid-eluting spacers and sponges are deemed integral supplies to the surgery itself and cannot be separately billed. Billing teams must immediately stop claiming these devices separately and update denial protocols.