Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.31
    OpenPayerPolicy UpdatesPulmonologyUnitedHealthcare Bronchial Policy Update | OpenPay…
    Ask Trek AI about this page
    CurrentUnitedHealthcarePolicy CS014NM.D

    Bronchial Thermoplasty (for New Mexico Only) UnitedHealthcare Community Plan Medical Policy

    Customize your policy alerts

    Sign up for UnitedHealthcare Policy CS014NM.D alerts

    Get alerted when Policy CS014NM.D changes without checking for updates manually.

    Monitor payer policy activity

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

    This policy governs coverage of bronchial thermoplasty for asthma for UnitedHealthcare Community Plan members in New Mexico. It states that bronchial thermoplasty is unproven and not medically necessary because evidence of efficacy is insufficient.

    Policy Summary
    PayerUnitedHealthcare
    PolicyBronchial Thermoplasty (for New Mexico Only)
    Policy CodePolicy CS014NM.D
    Change TypeSupporting-information update
    Effective DateOctober 1, 2026
    Next Review DateNot specified
    Key ActionBronchial thermoplasty for treating asthma is considered unproven and not medically necessary because evidence of efficacy is insufficient.
    SourceLink
    POLICY UPDATE CHANGES

    Clinical Evidence and References sections updated to reflect current information.

    New Mexico onlyGeographic application
    Not medically necessaryCoverage stance
    31661Referenced CPT code
    3 visitsTreatment course

    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.

    6 RCTs / 573Evidence base

    Bronchial Thermoplasty Coverage

    Bronchial Thermoplasty for Asthma

    Bronchial thermoplasty is not covered as medically necessary for treating asthma.

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

    The policy provides no positive coverage criteria or exceptions.

    Bronchial thermoplasty is not medically necessary for treating asthma because the evidence of efficacy is insufficient. The procedure is therefore considered unproven under this policy.

    Applicable Coding

    Applicable CPT CodeCPT
    31661Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 2 or more lobes

    Provider Guidance

    Denial Risk

    Insufficient evidence of efficacy

    Bronchial thermoplasty for treating asthma is considered unproven and not medically necessary because evidence of efficacy is insufficient.

    Clinical Background

    Asthma is a heterogeneous disease generally characterized by chronic airway inflammation, variable symptoms, and expiratory airflow limitation. Symptoms may include wheezing, shortness of breath, chest tightness, and cough, and can vary over time and in intensity.

    Key Definitions

    Bronchial thermoplasty
    Procedure typeMinimally invasive procedure
    Energy deliveryControlled thermal radiofrequency energy is delivered to the airway smooth muscle
    Delivery methodA specialized catheter is advanced through a flexible bronchoscope until it contacts the targeted airway wall
    Asthma
    Disease typeHeterogeneous disease
    Primary characteristicUsually characterized by chronic airway inflammation
    Associated featuresSymptoms include wheezing, shortness of breath, chest tightness, and/or cough, which may vary over time and in intensity together with expiratory airflow limitation
    Policy Summary
    PayerUnitedHealthcare
    PolicyBronchial Thermoplasty (for New Mexico Only)
    Policy CodePolicy CS014NM.D
    Change TypeSupporting-information update
    Effective DateOctober 1, 2026
    Next Review DateNot specified
    Key ActionBronchial thermoplasty for treating asthma is considered unproven and not medically necessary because evidence of efficacy is insufficient.
    SourceLink
    On This Page
    Bronchial Thermoplasty CoverageApplicable CodingProvider GuidanceClinical BackgroundKey Definitions