What insurance policy changes affect CPT 31298?

There are 15 tracked policy changes affecting CPT 31298, including updates from Ambetter, Humana. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 31298?

Payers that have issued tracked updates for CPT 31298 include: Ambetter, Humana.

How do I get notified when CPT 31298 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 31298. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 31298?

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.

31298 — A surgical procedure to examine and treat problems in the nasal passages, sinuses, and the space behind the nose using an endoscope.: Insurance Policy Changes

31298 Insurance Policy Changes

CPT 31298, in plain terms, covers A surgical procedure to examine and treat problems in the nasal passages, sinuses, and the space behind the nose using an endoscope. CPT 31298 is referenced in 15 tracked payer policy changes from Ambetter and Humana. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 31298 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Medium impact

Important Prior Authorization Updates: Effective October 1, 2026

Ambetter·Effective Oct 1, 2026

Ambetter from Arizona Complete Health is removing prior authorization requirements for genetic testing (CPT 86812, 86813, 86817), home services (HCPCS S9211, S9213, S9214), and transplant services (CPT 38208), while adding prior authorization requirements for sinus surgery procedures (CPT 31276, 31296, 31297, 31298). These changes take effect October 1, 2026, and aim to reduce administrative burden and simplify the PA process across markets and lines of business.

31298 Insurance Policy Changes

Important Prior Authorization Updates: Effective October 1, 2026

Important Prior Authorization Updates: Effective October 1, 2026

Important Prior Authorization Updates: Effective October 1, 2026

Important Prior Authorization Updates: Effective October 1, 2026

Important Prior Authorization Updates: Effective October 1, 2026

Important Prior Authorization Updates: Effective October 1, 2026

Important Prior Authorization Updates: Effective October 1, 2026

Important Prior Authorization Updates: Effective October 1, 2026

Important Prior Authorization Updates: Effective October 1, 2026

Important Prior Authorization Updates: Effective October 1, 2026

Important Prior Authorization Updates: Effective October 1, 2026

Important Prior Authorization Updates: Effective October 1, 2026

Important Prior Authorization Updates: Effective October 1, 2026

Sinonasal and Eustachian Tube Surgical Procedures - Medicare Advantage (Revised)

Sinonasal and Eustachian Tube Surgical Procedures - Medicare Advantage (Revised)