BALLOON SINUS OSTIAL DILATION FOR CHRONIC SINUSITIS AND EUSTACHIAN TUBE DILATION
Defines medical necessity, exclusions, limitations, coding, and regulatory background for balloon sinus ostial dilation (Balloon Sinuplasty) for chronic rhinosinusitis (CRS) and recurrent acute rhinosinusitis (RARS), and for Eustachian tube balloon dilation (ETBD) in adults and select pediatrics.
Removed tobacco use as an exclusion for Eustachian tube balloon dilation (ETBD).
Added medical necessity criteria for recurrent acute rhinosinusitis.
Added medically necessity criteria for chronic obstructive Eustachian tube dysfunction in pediatrics (ages 8-17).
Removed age criteria of 18 and up for eustachian tube dysfunction and added pediatric criteria.
Removed the strict ≥3-month predefined medical therapy regimen requirement for chronic rhinosinusitis, allowing individualized, patient-centered medical management prior to surgery.
Symptom duration threshold for ETBD changed from 6 months to 3 months.
Moved billing criteria for balloon sinus ostial dilation to the 'limitations' section.
Made editorial and grammatical updates to improve clarity.