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AAO-HNS Opposition Leads to Positive Update on United Healthcare’s Rhinoplasty and Nasal Procedures Policy

AAO-HNS Opposition Leads to Positive Update on United Healthcare’s Rhinoplasty and Nasal Procedures Policy

Following advocacy efforts by the AAO-HNS and the American Academy for Facial Plastic and Reconstructive Surgery (AAFPRS), on June 1 United Healthcare (UHC) updated its coverage policy to reflect that septoplasty is once again allowed to be performed at the same time as a nasal valve procedure/repair. This revision to the company’s policy, Rhinoplasty and Other Nasal Surgeries, reversed the January 1 UHC decision requiring these procedures to be performed in a staged fashion rather than concomitantly. The AAO-HNS advocated its opposition to United through written comments and other outreach activities. The Academy appreciates this policy update and the removal of the unnecessary prerequisite requirement subjecting certain patients with nasal obstructions to multiple individual procedures.

On January 27, the Academy sent comments to United Healthcare (UHC) regarding revisions made to the coverage criteria in its Rhinoplasty and Other Nasal Surgeries policy. As updated, the policy could require patients with nasal obstructions to receive unnecessary nasal surgery given their individual clinical circumstances. This prerequisite requirement would subject certain patients to multiple individual procedures, incurring both increased risk and costs, and will lengthen the time to resolve the airway obstruction. The Academy requested that UHC reverse this harmful change in the coverage criteria of its policy and will update members with new developments

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