Will Insurance Pay For A Septorhinoplasty?

Q: Dr. Eppley, I have a deviated nose and feel pressure in my nasal bones. ENT doctor said nasal passage was clear from what he could see and prescribed allergy meds for constant stuffiness and post nasal drainage. Wondering if any chance insurance would cover any of my deviated nose repair procedure to improve how I breathe and the way the nose looks. 

A: Insurance can cover internal nasal surgery for breathing issues such as septoplasty and turbinate reductions. These are often done as part of many rhinoplasties and fall under the name of septorhinoplasty when both functional and aesthetic nasal changes are done during the same operation.

Before one can submit to insurance to determine whether coverage is possible, this would require a paranasal CT scan to first be obtained to look at the internal nasal anatomy and see what abnormalities exist. If structural problems exist that block the nasal airway then a predetermination letter can be submitted to insurance  to determine whether they would cover the functional surgery to correct it. You can not submit a predetermination letter without a CT scan to document what anatomic abnormalities exist inside the nose.The aesthetic part of the rhinoplasty (any external changes) would not be covered by insurance.

Dr. Barry Eppley

Indianapolis Indiana