ModifiedPremera Blue Cross of WashingtonPolicy 7.01.610

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

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Coverage of cryoablation, radiofrequency ablation, laser ablation, and posterior nasal nerve resection for allergic or nonallergic chronic rhinitis; all listed 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 ReviewAug 1, 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

Posterior nasal nerve resection, or neurectomy, for chronic rhinitis was added as investigational.

Policy 7.01.610 replaced policy 7.01.168 for cryoablation, radiofrequency ablation, and laser ablation for chronic rhinitis.

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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 ReviewAug 1, 2026

Next Review DateN/A

SourceLink

POLICY UPDATE CHANGES

Posterior nasal nerve resection, or neurectomy, for chronic rhinitis was added as investigational.

Policy 7.01.610 replaced policy 7.01.168 for cryoablation, radiofrequency ablation, and laser ablation for chronic rhinitis.

Investigational Procedures

Cryoablation, radiofrequency ablation, laser ablation, and posterior nasal nerve resection

The following procedures are considered investigational for allergic or nonallergic chronic rhinitis:

Investigational procedures

Cryoablation for chronic rhinitis is considered investigational.
Example: Clarifix device.
Radiofrequency ablation for chronic rhinitis is considered investigational.
Example: RhinAer stylus.
Laser ablation for chronic rhinitis is considered investigational.
Posterior nasal nerve resection: Resection (neurectomy) of the posterior nasal nerve for chronic rhinitis is considered investigational.

Posterior nasal nerve resection or neurectomy

The procedure is considered investigational.

Posterior nasal nerve resection status: Resection (neurectomy) of the posterior nasal nerve for chronic rhinitis is considered investigational.

No medical-necessity criteria are provided in this policy.

Codes and Outcome Measures

CPT CodesCPT

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).

Historical CPT codes addedCPT

31242	New CPT code added in a coding update.
31243	New CPT code added in a coding update.

Historical HCPCS codeHCPCS

C9771

HCPCS code with a term date added.

Historical unlisted codes removedCPT

30999	Unlisted nasal procedure code removed after establishment of CPT codes for RhinAer and ClariFix.
31299	Unlisted nasal procedure code removed after establishment of CPT codes for RhinAer and ClariFix.

Ongoing and unpublished clinical trialsmixed

NCT06599736	Effect of Temperature-Controlled Radiofrequency Ablation of the Posterior Nasal Nerve on Inflammatory Biomarkers in Patients With Allergic and Nonallergic Chronic Rhinitis.
NCT06992037	An Ambispective, Multicenter, Registry Study Comparing Clinical Outcomes of Participants Receiving Surgical Interventions for the Treatment of Nasal Airway Obstruction (The DUO Study).
NCT05937308	Interventional Registry to Collect Real-World Evidence of the NEUROMARK System in Subjects With Chronic Rhinitis.

Reflective Total Nasal Symptom Score

Score changeChange in score of 1 point

Proposed baseline changeA ≥30% change from baseline has been proposed

Minimum assessment durationAt least 6 months or longer

NOSE

Minimally clinically important differenceNo minimally clinically important difference established in the policy table

ScaleFive patient-reported items are scored from 0 to 4 and summed, then multiplied by 5; total range is 0 to 100

Coverage and Denial Guidance

Denial Risk

Investigational Chronic Rhinitis Ablation

Coverage is not provided for cryoablation, radiofrequency ablation, or laser ablation for chronic rhinitis, whether allergic or nonallergic. These procedures are considered investigational and may be denied on that basis.

Cryoablation (e.g., ClariFix device)
Radiofrequency ablation (e.g., RhinAer stylus)
Laser ablation

Denial Risk

Investigational Posterior Nasal Nerve Resection

Resection (neurectomy) of the posterior nasal nerve for chronic rhinitis, also referred to as selective postganglionic nerve resection, is considered investigational and may be denied on that basis.

Chronic Rhinitis and Treatment Context

Chronic rhinitis encompasses allergic, nonallergic, and mixed rhinitis. Symptoms may include rhinorrhea, nasal congestion or obstruction, nasal itching, sneezing, mucous in the throat, and impaired quality of life. Initial medical management commonly includes steroids, anticholinergics, nasal decongestants, antihistamines, and, when appropriate, allergy shots. Approximately 10% to 22% of patients may have persistent symptoms despite medical therapy and may be considered to have refractory chronic rhinitis.

Ablation and posterior nasal nerve procedures are intended to interrupt parasympathetic stimulation of the nasal mucosa, reducing submucosal gland secretions and blood flow. Available approaches include cryotherapy, radiofrequency ablation, laser ablation, and surgical intervention directed at the posterior nasal nerve; minimally invasive procedures may be performed endoscopically. The policy concludes that evidence is insufficient to establish improvement in net health outcomes for these procedures.

Key Terms

Posterior nasal nerve

Nerve fibersIncludes fibers from the maxillary nerve and the postganglionic pterygoid nerve

Anatomical originEmerges from the sphenopalatine ganglion

Effect of resectionResection purportedly severs the parasympathetic supply to the nose

Ablation therapy

CryoablationUses extreme cold to freeze nerve endings near the back of the nose

Radiofrequency ablationUses an electric current to heat a small area of nerve tissue

Laser ablation