ModifiedPremera Blue Cross of WashingtonPolicy 7.01.610

Cryoablation, Radiofrequency Ablation, and Laser Ablation for Treatment of Chronic Rhinitis

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This policy governs coverage of cryoablation, radiofrequency ablation, laser ablation, and posterior nasal nerve resection for allergic or nonallergic chronic rhinitis. It is intended to inform providers when these procedures are considered investigational.

Policy Summary

PayerPremera Blue Cross of Washington

PolicyCryoablation, Radiofrequency Ablation, and Laser Ablation for Treatment of Chronic Rhinitis

Policy CodePolicy 7.01.610

Change TypeModified

Effective DateFebruary 5, 2027

Last ReviewOct 13, 2026

Next Review DateN/A

Key ActionDo not expect coverage for cryoablation, radiofrequency ablation, laser ablation, or posterior nasal nerve resection for chronic rhinitis because these procedures are considered investigational.

SourceLink

POLICY UPDATE CHANGES

The policy adds that resection (neurectomy) of the posterior nasal nerve for chronic rhinitis is considered investigational.

The policy was replaced and renumbered without changing the previously stated coverage conclusions for cryoablation, radiofrequency ablation, and laser ablation.

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ModifiedPremera Blue Cross of WashingtonPolicy 7.01.610

Cryoablation, Radiofrequency Ablation, and Laser Ablation for Treatment of Chronic Rhinitis

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Sign up for premerabluecrossofwashington Policy 7.01.610 alerts

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Policy Summary

PayerPremera Blue Cross of Washington

PolicyCryoablation, Radiofrequency Ablation, and Laser Ablation for Treatment of Chronic Rhinitis

Policy CodePolicy 7.01.610

Change TypeModified

Effective DateFebruary 5, 2027

Last ReviewOct 13, 2026

Next Review DateN/A

SourceLink

POLICY UPDATE CHANGES

The policy adds that resection (neurectomy) of the posterior nasal nerve for chronic rhinitis is considered investigational.

The policy was replaced and renumbered without changing the previously stated coverage conclusions for cryoablation, radiofrequency ablation, and laser ablation.

Procedural approaches addressed

InvestigationalPosterior nasal nerve resection status

3FDA-cleared chronic-rhinitis devices

0FDA-cleared laser ablation devices

Investigational Procedures

Procedures Considered Investigational

The following procedures for chronic rhinitis are considered investigational:

Investigational procedures

Cryoablation for chronic rhinitis, whether allergic or nonallergic (e.g., the ClariFix device).
Radiofrequency ablation for chronic rhinitis, whether allergic or nonallergic (e.g., the RhinAer stylus).
Laser ablation for chronic rhinitis, whether allergic or nonallergic.
Resection (neurectomy) of the posterior nasal nerve for chronic rhinitis.

Posterior Nasal Nerve Resection

Posterior nasal nerve resection (neurectomy) for chronic rhinitis is considered investigational.

Resection (neurectomy) of the posterior nasal nerve for chronic rhinitis, also referred to as selective postganglionic posterior nasal nerve resection.

Procedure Codes

CPTCPT

30117	Excision or destruction (e.g., laser), intranasal lesion; internal approach.
31242	Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve (use to report: RhinAer).
31243	Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve (use to report: Clarifix)

Provider and Claims Guidance

Denial Risk

Investigational chronic rhinitis procedures

Claims for cryoablation, radiofrequency ablation, laser ablation, or posterior nasal nerve resection (neurectomy) performed for allergic or nonallergic chronic rhinitis are subject to denial because these procedures are considered investigational.

Denial Risk

Posterior nasal nerve resection is investigational

Posterior nasal nerve resection (neurectomy) for chronic rhinitis is considered investigational and is a basis for noncoverage.

Clinical Context

Chronic rhinitis is a common condition involving inflammation of the nasal passages. It includes allergic, nonallergic, and mixed rhinitis and may cause rhinorrhea, nasal congestion or obstruction, itching, sneezing, mucus in the throat, and impaired quality of life.

Initial management commonly includes pharmacotherapy such as nasal steroids, anticholinergics, nasal decongestants, and antihistamines; allergy shots may also be used in appropriate patients. Approximately 10%–22% of patients continue to have symptoms despite medical therapy. Persistent symptoms after adequate medical treatment are referred to as refractory chronic rhinitis, for which invasive interventions targeting the posterior nasal nerve may be considered.

Terms and Evidence Definitions

Posterior Nasal Nerve

Anatomic compositionIncludes fibers from the maxillary nerve and the postganglionic pterygoid nerve.

OriginEmerges from the sphenopalatine ganglion.

Related functionProvides parasympathetic nerve supply relevant to the nasal mucosa.

Posterior Nasal Nerve Resection/Neurectomy

Other namePosterior nasal nerve resection is also called neurectomy.

ProcedureSurgical resection or destruction of the posterior nasal nerve.

Purported mechanism

Policy Summary

PayerPremera Blue Cross of Washington

PolicyCryoablation, Radiofrequency Ablation, and Laser Ablation for Treatment of Chronic Rhinitis

Policy CodePolicy 7.01.610

Change TypeModified

Effective DateFebruary 5, 2027

Last ReviewOct 13, 2026

Next Review DateN/A

SourceLink

On This Page

Severs or interrupts parasympathetic stimulation of the nose, with the intended effect of reducing submucosal gland secretions and blood flow.

Refractory Chronic Rhinitis

DefinitionChronic rhinitis that does not improve after adequate medical therapy.

Common preceding treatmentMedical management may include steroids, anticholinergics, nasal decongestants, and antihistamines.

Potential next stepPatients with persistent symptoms may be considered for invasive interventions to block the posterior nasal nerve.

Grade of Evidence C

Evidence designationGrade C.

Evidence baseThe body of evidence consists primarily of observational studies.

Study designsExamples include case-control and cohort studies.

Policy Level: Option

MeaningAn option policy level indicates that evidence quality may be uncertain or that well-designed studies have shown little clear advantage of one approach over another.

Clinical flexibilityOptions offer clinicians flexibility in decision-making, although they may set boundaries on alternatives.

Patient preferencePatient preference should have a substantial role in clinical decision-making.

510(k) Clearance

Basis for clearanceA 510(k) clearance is based on substantial equivalence to a predicate device.

Regulatory meaningThe process evaluates equivalence in design and intended use rather than constituting a new premarket approval determination of clinical effectiveness.

Policy implicationFDA 510(k) clearance does not by itself establish clinical efficacy or improved patient outcomes.