What insurance policy changes affect CPT 31242?

There are 7 tracked policy changes affecting CPT 31242, including updates from Humana, Aetna, Blue Cross & Blue Shield of Mississippi. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 31242?

Payers that have issued tracked updates for CPT 31242 include: Humana, Aetna, Blue Cross & Blue Shield of Mississippi.

How do I get notified when CPT 31242 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 31242. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 31242?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

31242 — A doctor uses radiofrequency energy to burn away abnormal tissue inside your nose or sinuses to improve breathing.: Insurance Policy Changes

31242 Insurance Policy Changes

CPT 31242, in plain terms, covers A doctor uses radiofrequency energy to burn away abnormal tissue inside your nose or sinuses to improve breathing. CPT 31242 is referenced in 7 tracked payer policy changes from Humana, Aetna, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 31242 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Medium impact

Intranasal Ablation (CPB 0592, reviewed 2026-09-18)

Aetna·Identified Oct 4, 2026

Aetna updated its Clinical Policy Bulletin 0592 on intranasal ablation procedures, clarifying coverage criteria for radiofrequency volumetric tissue reduction (RFVTR/Somnoplasty) of inferior turbinates for chronic nasal obstruction due to mucosal hypertrophy. The policy designates multiple ablation techniques and procedures as experimental/investigational, including coblation, cryoablation, RhinAer, temperature-controlled radiofrequency neurolysis, and NEUROMARK System. Billing teams must verify specific procedure type and diagnosis before claiming coverage under CPT 30801/30802, as many related codes and indications are explicitly non-covered.

31242 Insurance Policy Changes

Minimally Invasive Sinonasal and Eustachian Tube Procedures - MEDICAID - VIRGINIA (New)

Minimally Invasive Sinonasal and Eustachian Tube Procedures - MEDICAID - SOUTH CAROLINA (New)

Minimally Invasive Sinonasal and Eustachian Tube Procedures - MEDICAID - MICHIGAN (New)

Minimally Invasive Sinonasal and Eustachian Tube Procedures - MEDICAID - ILLINOIS (New)

Intranasal Ablation (CPB 0592, reviewed 2025-09-10)

Intranasal Ablation (CPB 0592, reviewed 2026-09-18)

Cryoablation, Radiofrequency Ablation, and Laser Ablation for Treatment of Chronic Rhinitis