Does Insurance Cover Balloon Sinuplasty?

Most insurance companies cover the treatment, although different firms have varied clearance requirements. Each company has its own set of criteria for deciding whether or not a patient need therapy.

We always perform a CT scan and exhaust all medical treatment options with drugs before prescribing a procedural option in order to get it approved. Most insurance companies will cover the treatment if the doctor recommends it, however some smaller companies may claim that balloon sinuplasty is “experimental or investigational” in order to avoid paying for it.

If your insurance company denies coverage, our office has procedures in place to explore if a physician peer review or appeal can overturn the decision.

Will insurance cover a balloon sinuplasty?

The overall benefit of balloon sinuplasty has been discovered by insurance companies. When this operation is medically essential, most insurance companies and Medicare will fund it. To find out if sinuplasty is covered by your insurance, contact your provider.

How much does it cost for balloon sinuplasty?

A balloon sinuplasty can cost anywhere from $3,000 to $7,000, depending on the practitioner doing the procedure. In comparison to an operating theatre, surgery in an office or clinic is usually far less expensive. Some insurance companies still label this operation as experimental or “not medically required” because it is so new. In 2014, the American Academy of Otolaryngology published a statement urging all insurance companies to consider paying for this treatment.

How long does a balloon sinuplasty last?

Numerous studies have shown that the benefits of Balloon SinuplastyTM remain for at least two years in the vast majority of patients, which is comparable to or better than the results of traditional sinus procedures. The length of time your sinuses remain open is determined by the severity of your sinus condition as well as other personal health considerations. However, we have every reason to believe that the progress will continue.

Is balloon sinuplasty permanent?

In Dr. Cohen’s hands, balloon sinuplasty and turbinate reduction are permanent in over 90% of patients if the post-procedure guidelines are carefully followed. Many people can avoid sinus infections for the rest of their lives, depending on how much remodeling the balloon makes to their passageways during the surgery. This also eliminates the need for future treatments to permanently remove congested nasal passages and congestion.

Does insurance cover balloon?

The average cost of a gastric balloon is $8,150. Although your doctor may be able to get part of the costs paid, it is usually not covered by insurance.

Tax deductions and other doctor-specific discounts can often minimize the cost.

This page will tell you all you need to know about the gastric balloon treatment and how to pay for it.

Will balloon sinuplasty stop snoring?

Yes, procedures such as balloon sinuplasty can help you stop snoring. Snoring can be relieved by balloon sinuplasty, a minimally invasive sinus surgery. Snoring alleviation might have a favorable impact on your overall health. Snoring isn’t simply annoying to those around you; it can also be harmful to your health. Chronic migraines, falling asleep at work, and heart problems are just a few of the snoring’s negative effects.

Who is a good candidate for balloon sinuplasty?

Those with moderate to mild sinus illness, according to Dr. Tran, are the best candidates for balloon sinuplasty. The surgery may not be beneficial to those who have more severe nasal anomalies.

What are the side effects of balloon sinuplasty?

Balloon sinuplasty, like any surgical operation, might have minor side effects, although they normally go away quickly. For about a week after surgery, patients may have bloody leakage, congestion, grogginess, discomfort, and exhaustion as a result of balloon sinus dilatation.

What are the risks of balloon sinuplasty?

After local anesthesia, any office nasal operation carries risks such as nosebleeds, dizziness, discomfort, and a fast heartbeat. With a sinus puncture under your lip, you may suffer numbness in your cheeks or lips. Balloon sinuplasty is less intrusive and has a reduced complication rate than standard sinus surgery.

Tissue Injury: The expansion poses a modest risk of mucosal/tissue damage.

Optical Damage: Because the treatment is conducted near your eye, the optic nerve may be affected; however, this is uncommon.