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November 2018 Medical Policies

EmblemHealth·ENT (Ear, Nose & Throat)·Provider News
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

EmblemHealth updated their medical policy for Balloon Sinuplasty procedures. This policy change affects coverage criteria and potentially prior authorization requirements for this ENT procedure used to treat chronic sinusitis.

Action Required

Action needed
Immediately: Review EmblemHealth's updated Balloon Sinuplasty policy at the provided URL to determine specific coverage criteria changes. Billing team should verify current prior authorization requirements and update any internal protocols for EmblemHealth members requiring this procedure. Contact EmblemHealth directly if specific billing code or documentation changes are unclear from the policy text.

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