Partial Rhinectomy, Rhinoplasty, Vestibular Stenosis Repair and Septoplasty - (0119)

Cigna covers partial rhinectomy, rhinoplasty, vestibular stenosis repair and septoplasty only for specific functional indications (malignancy, extensive benign lesions, severe trauma, cleft-related deformities with age/function criteria, vestibular stenosis with positive Cottle/lateralization test, and septal deviation causing obstruction or interfering with CPAP with documented AHI ≥15) and excludes purely cosmetic procedures or indications not listed. Key requirements include photographic documentation for many rhinoplasty cases, usually a ≥6‑week trial of conservative medical therapy for trauma-related obstruction, demonstration of airway improvement with valve maneuvers for vestibular stenosis, sleep-study documentation when CPAP interference is claimed, plan-dependent coverage limits, and several procedures (absorbable nasal implants, radiofrequency nasal valve procedures, balloon dilation septoplasty) are considered experimental/unproven.

"Partial Rhinectomy is considered medically necessary for ANY of the following indications: Malignant neoplasm of the nasal structures that cannot be adequately treated by less invasive surgical pro..."