Medical Policy Implementation: Balloon Dilation of the Eustachian Tube

Effective April 22, 2019, Horizon BCBSNJ will implement a new medical policy, Balloon Dilation of the Eustachian Tube. We encourage you to access our Medical Policy Manual to review this medical policy content.¹

This policy’s criteria and guidelines address our position on balloon dilation of the eustachian tube for the treatment of members with chronic eustachian tube dilatory dysfunction.

The implementation of this policy will not result in a material adverse change to how we currently process claims for services provided to your patients enrolled in Horizon BCBSNJ commercial, Administrative Services Only (ASO) or Medicare Advantage (MA) plans.

¹ The content of Horizon BCBSNJ medical policies that apply to Horizon BCBSNJ MA plans may include reference to pertinent National Coverage Determinations (NCDs) and/or Local Coverage Determinations (LCDs). We follow Centers for Medicare & Medicaid Services (CMS) guidelines, NCDs and/or LCDs in our processing of claims for services provided to our MA members. For those services where no LCD or NCD exists, claims for MA members will be processed based on our policy guidelines.