Surgical Treatments to Control Drooling (Sialorrhea)

Medically necessary surgical options for refractory sialorrhea when selection criteria are met include excision of the submandibular gland (± parotid duct ligation), four‑duct ligation, various bilateral parotid duct diversion procedures (with or without submandibular gland excision or duct ligation), relocation of the submandibular ducts (± sublingual gland removal), and tympanic/chorda tympani neurectomy; transoral submandibular ganglion neurectomy is experimental/investigational and not covered, and any surgery is considered cosmetic if criteria are not met. Coverage requires BOTH significant morbidity from drooling (e.g., skin maceration, poor oral hygiene, dehydration) AND failure to respond to appropriate physical therapy and drug therapy (covered diagnoses when criteria are met: ICD‑10 K11.1, K11.7).

"The following surgical procedures to control excessive drooling may be considered medically necessary for members who meet the selection criteria listed above: Parotid duct diversion, bilateral, wi..."