CommercialCoverageMedium impact
11.16.06k, Balloon Catheter Dilation of Sinus Ostia for Treatment of Chronic Rhinosinusitis or Recurrent Acute Rhinosinusitis
Independence Blue Cross·ENT (Ear, Nose & Throat)·Medical Policy
Effective date
Apr 2, 2025
We identified it
Jun 19, 2026
Summary
Policy 11.16.06k has been reissued effective 04/02/2025 regarding balloon catheter dilation of sinus ostia for chronic rhinosinusitis or recurrent acute rhinosinusitis treatment. The billing team must review the full policy text to identify coverage criteria, billing code requirements, and any prior authorization mandates specific to this procedure.
Action Required
By 04/02/2025: Billing team must obtain and review the complete policy text from the provided URL to extract specific CPT/HCPCS codes, prior authorization requirements, and documentation standards. Update billing system rules, encounter forms, and staff training materials accordingly. Notify ENT providers of any changes to coverage criteria or medical necessity documentation requirements. Failure to implement policy requirements may result in claim denials.