CommercialCoverageMedium impact
11.16.08f, Steroid-Eluting Sinus Stents and Implants
Independence Blue Cross·ENT (Ear, Nose & Throat)·Medical Policy
We identified it
Sep 3, 2026
Summary
Independence Blue Cross reissued policy 11.16.08f confirming that steroid-eluting sinus stents and implants (including PROPEL and SINUVA devices) remain experimental/investigational and are NOT covered under commercial medical benefits. This is a reaffirmation of the company's continuing position with no coverage changes. Billing teams must deny all claims for these devices and related procedures.
Action Required
Immediately: Billing team must ensure all claims for steroid-eluting sinus stents and implants are denied as experimental/investigational. Specifically: (1) Deny any claims submitted with CPT 31299 when associated with steroid-eluting implant placement; (2) Deny claims with HCPCS J7402 (SINUVA mometasone implant) and S1091 (PROPEL stent); (3) Update billing system to automatically flag and reject these codes for Independence Blue Cross commercial plans; (4) Educate providers and front desk staff that these devices are non-covered; (5) Prepare standard denial letters citing policy 11.16.08f. Failure to deny will result in overpayments and potential recovery actions from the payer.