Balloon ostial dilation of the sinus involves placing a catheter-based inflatable device in the sinus ostium, inflating the balloon, and dilating the ostium. General anesthesia may be needed to minimize patient movement.
Balloon sinus ostial dilation as a stand-alone procedure is considered medically necessary in the sinus being considered for dilation (i.e., frontal, maxillary or sphenoid) for the treatment of chronic sinusitis when ALL of the following criteria are met:
Balloon sinus ostial dilation is considered experimental, investigational or unproven for all other indications and therefore non-covered.
** Balloon sinus ostial dilation is contraindicated in the presence of a mass lesion filling the sinus cavity involved or in the case of inspissated chronic fungal sinusitis.
Use of a catheter-based inflatable device (balloon sinus ostial dilation) may be considered medically necessary during functional endoscopic sinus surgery (FESS).
The use of implantable steroid-eluting sinus stents (e.g. Propel™) is considered experimental/investigational and, therefore, non-covered for postoperative treatment following endoscopic sinus surgery because the safety and/or effectiveness of this service cannot be established by the available published peer-reviewed literature.
Covered Dx codes for Balloon Ostial Dilation (31295, 31296, 31297, 31298)