Medicare AdvantageCoverageMedium impact
Balloon Dilation of Eustachian Tube
Blue Cross Blue Shield of Rhode Island·RI · ENT (Ear, Nose & Throat)·Physician / Facility
Effective date
Nov 1, 2018
We identified it
Jun 20, 2026
Summary
Effective November 1, 2018, Balloon Dilation of the Eustachian Tube (HCPCS C9745) is not covered for BlueCHiP Medicare plans and considered not medically necessary for Commercial products. This means claims for this procedure will be denied for both plan types.
Action Required
Immediately: Billing team must update system to deny/flag HCPCS code C9745 for Balloon Dilation of Eustachian Tube for all BlueCHiP Medicare and Commercial plans. Update encounter forms to alert providers that this procedure is not covered. Claims submitted will be denied.