What insurance policy changes affect code J31.0?

There are 4 tracked policy changes affecting code J31.0, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code J31.0?

Payers that have issued tracked updates for code J31.0 include: Aetna.

How do I get notified when code J31.0 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code J31.0. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for code J31.0?

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.

PAYER POLICY CHANGES

J31.0 Insurance Policy Changes

ICD-10 J31.0 is officially defined as "Chronic rhinitis." code J31.0 is referenced in 4 tracked payer policy changes from Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code J31.0 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Aetna · Identified Oct 4, 2026Medium impact
Intranasal Ablation (CPB 0592, reviewed 2026-09-18)
Aetna considers radiofrequency volumetric tissue reduction (RFVTR, Somnoplasty) medically necessary for chronic nasal obstruction due to mucosal hypertrophy of the inferior turbinates, and considers RFVTR of the turbinates for snoring not medically necessary. CPT 30801 and 30802 are covered if the selection criteria are met, and CPT 31242 and 31243 are not covered for the indications listed. Coblation non-thermal volumetric tissue reduction for turbinate hypertrophy, coblation-assisted turbinoplasty for allergic rhinitis, cryoablation for chronic nasal obstruction or chronic rhinitis, radiofrequency ablation for rhinitis medicamentosa, RFVTR of the turbinates for obstructive sleep apnea, the RhinAer procedure, temperature-controlled radiofrequency neurolysis for chronic rhinitis, and the NEUROMARK System for chronic rhinitis are considered experimental, investigational, or unproven because the effectiveness and safety of these approaches has not been established.
Aetna · Identified Aug 16, 2026Medium impact
Intranasal Ablation (CPB 0592, reviewed 2025-09-10)
Aetna considers radiofrequency volumetric tissue reduction (RFVTR, Somnoplasty) medically necessary for chronic nasal obstruction due to mucosal hypertrophy of the inferior turbinates, and considers RFVTR of the turbinates for snoring not medically necessary. Aetna considers coblation turbinate reduction, coblation-assisted turbinoplasty for allergic rhinitis, cryoablation for chronic nasal obstruction or chronic rhinitis, radiofrequency ablation for rhinitis medicamentosa, RFVTR for obstructive sleep apnea, the RhinAer procedure, temperature-controlled radiofrequency neurolysis, and the NEUROMARK System experimental, investigational, or unproven for the uses listed in the policy. CPT 30801 and 30802 are covered when the selection criteria are met.
Aetna · Identified Aug 16, 2026Medium impact
Sinus Surgeries (CPB 0937, reviewed 2026-04-10)
Aetna's Clinical Policy Bulletin 0937 treats endoscopic sinus surgery as medically necessary for specific indications, including allergic fungal rhino-sinusitis with CT evidence, antro-choanal polyp, chronic rhino-sinusitis longer than 12 continuous weeks with or without nasal polyps that has failed maximal medical treatment and shows objective CT evidence, recurrent acute rhino-sinusitis meeting listed criteria, sinusitis complications, and mucocele, and as experimental, investigational, or unproven for all other indications. Revision surgery requires at least 12 weeks since the previous surgery, chronic rhino-sinusitis for at least 12 continuous weeks, failure of at least one 5 to 7 day course of antibiotics since the previous surgery, and persistent objective CT evidence of sinus disease. Balloon sinus ostial dilation is medically necessary for uncomplicated sinusitis without nasal polyposis when the Appendix criteria are met and is experimental for listed cases such as nasal polyposis grade 2 or greater, repeat balloon procedures, and Samter's triad, while sphenopalatine artery ligation with posterior nasal nerve ablation is experimental for vasomotor rhinitis.
Aetna · Identified Aug 16, 2026Medium impact
Septoplasty and Rhinoplasty (CPB 0005, reviewed 2026-03-12)
Aetna Clinical Policy Bulletin 0005 treats septoplasty as medically necessary for specific criteria, including documented recurrent sinusitis from a deviated septum not relieved by medical and antibiotic therapy, recurrent epistaxis related to a septal deformity, continuous nasal airway obstruction not responding to 4 or more weeks of appropriate medical therapy, and septoplasty done with cleft palate repair. Rhinoplasty is medically necessary only in limited circumstances, such as a nasal deformity from congenital cleft lip and/or palate, removal of a nasal dermoid, or an individually reviewed case of vestibular stenosis, and the policy considers rhinoplasty cosmetic for all other indications. Extracorporeal septoplasty for revision of a deviated septum, nasal valve suspension, septal swell body ablation, balloon septoplasty, and absorbable nasal implants for nasal valve reconstruction are listed as experimental, investigational, or unproven. The policy was last reviewed 03/12/2026.

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

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

Sinus Surgeries (CPB 0937, reviewed 2026-04-10)

Septoplasty and Rhinoplasty (CPB 0005, reviewed 2026-03-12)

What insurance policy changes affect code J31.0?

Which payers have updated policy for code J31.0?

How do I get notified when code J31.0 policy changes?

Why do payers change policies for code J31.0?