CurrentUnitedHealthcare Community PlanPolicy CS014KY.07

Bronchial Thermoplasty (for Kentucky Only)

Customize your policy alerts

Sign up for UnitedHealthcare Policy CS014KY.07 alerts

Get alerted when Policy CS014KY.07 changes without checking for updates manually.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

This Kentucky-only medical policy addresses coverage of bronchial thermoplasty for asthma and considers the procedure unproven and not medically necessary because evidence is insufficient to establish efficacy.

Policy Summary

PayerUnitedHealthcare Community Plan

PolicyBronchial Thermoplasty (for Kentucky Only)

Policy CodePolicy CS014KY.07

Change TypeSupporting information update

Effective DateOctober 1, 2026

Next Review DateNot specified

Key ActionBefore applying the policy, check the member-specific benefit plan document and any applicable federal or state mandates.

SourceLink

POLICY UPDATE CHANGES

The Clinical Evidence and References sections were updated with current information.

Kentucky onlyPolicy application

Not medically necessaryCoverage stance

573Individuals in six RCTs

2.95Severe exacerbation rate ratio

OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.

CurrentUnitedHealthcare Community PlanPolicy CS014KY.07

Bronchial Thermoplasty (for Kentucky Only)

Customize your policy alerts

Sign up for UnitedHealthcare Policy CS014KY.07 alerts

Get alerted when Policy CS014KY.07 changes without checking for updates manually.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Policy Summary

PayerUnitedHealthcare Community Plan

PolicyBronchial Thermoplasty (for Kentucky Only)

Policy CodePolicy CS014KY.07

Change TypeSupporting information update

Effective DateOctober 1, 2026

Next Review DateNot specified

Key ActionBefore applying the policy, check the member-specific benefit plan document and any applicable federal or state mandates.

SourceLink

POLICY UPDATE CHANGES

The Clinical Evidence and References sections were updated with current information.

Kentucky onlyPolicy application

Not medically necessaryCoverage stance

573Individuals in six RCTs

2.95Severe exacerbation rate ratio

Bronchial Thermoplasty for Asthma

Bronchial thermoplasty is not medically necessary for treating asthma.

Coverage determination: Bronchial thermoplasty is unproven and not medically necessary for treating asthma due to insufficient evidence of efficacy.

The policy does not provide affirmative coverage criteria.

Bronchial thermoplasty for treating asthma is excluded as unproven and not medically necessary because available evidence is insufficient to establish efficacy.

Bronchial thermoplasty is not medically necessary for treating asthma because the evidence is insufficient to establish its efficacy.

Applicable and Product Codes

Applicable CodesCPT

31661

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 2 or more lobes

FDA Product CodeFDA

OOY	Product code for BT systems in the FDA database

Forced expiratory volume in 1 second

MeasureForced expiratory volume in 1 second (FEV1)

ThresholdLess than 60% of predicted value

Clinical contextIndividuals with severe obstructive asthma at this lung-function level require further study; those with FEV1 below 60% of predicted value were excluded from the pivotal sham-controlled study.

Coverage Decision

Denial Risk

Unproven and Not Medically Necessary

Bronchial thermoplasty is unproven and not medically necessary for treating asthma because evidence is insufficient to establish efficacy. Apply independent clinical judgment when evaluating treatment options and coverage-related decisions.

Clinical Background

Asthma is a heterogeneous disease characterized by chronic airway inflammation, variable symptoms, and expiratory airflow limitation. Bronchial thermoplasty is a minimally invasive procedure intended for adults with severe persistent asthma that is not well controlled with medications; it uses thermal radiofrequency energy to reduce airway smooth muscle mass and responsiveness.

Key Terms

Bronchial thermoplasty

ProcedureA minimally invasive procedure for adults with severe persistent asthma that is not well controlled with medications.

Treatment approachA specialized catheter delivers controlled thermal radiofrequency energy to airway smooth muscle through a flexible bronchoscope.

Treatment scheduleBronchial thermoplasty is administered during three outpatient visits approximately three weeks apart.

Evidence contextThe policy cites insufficient conclusive evidence of safety and efficacy, including uncertainty about long-term benefits and safety.

Asthma

Disease typeA heterogeneous disease usually characterized by chronic airway inflammation.