SURG.00132 Drug-Eluting Devices for Maintaining Sinus Ostial Patency

This policy addresses drug-eluting sinus implants/stents used to maintain sinus ostial patency or treat nasal polyps, such as the Propel family (Propel, Propel Mini, Propel Contour) and SINUVA, often placed after functional endoscopic sinus surgery for chronic rhinosinusitis. Anthem considers these devices investigational/experimental and not medically necessary for all indications; therefore, they are not covered. No exceptions are noted, and noncoverage applies to all uses, including post-FESS and treatment of nasal polyps.

"The use of drug-eluting devices for maintaining sinus ostial patency or the treatment of nasal polyps is consideredinvestigational and not medically necessaryfor all indications."

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