31299 CPT® code: payer coverage and prior authorization33 of 34 payer prior-auth lists that name 31299 require prior authorization or set conditions: Blue Cross and Blue Shield of Texas, Cigna, HealthSpring, Humana, Molina Complete Care (Virginia), Molina Healthcare of Arizona, Molina Healthcare of California, Molina Healthcare of Florida, Molina Healthcare of Idaho, Molina Healthcare of Iowa, Molina Healthcare of Michigan, Molina Healthcare of Nevada, Molina Healthcare of New Mexico, Molina Healthcare of Ohio, Molina Healthcare of South Carolina, Molina Healthcare of Texas, Molina Healthcare of Utah, Molina Healthcare of Washington, Molina Healthcare of Wisconsin, Molina Healthcare, Inc. (national grid), and others.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Cigna | ACA/IFP | All | prior auth required | May be delegated to eviCore for some clients | Oct 1, 2006 | Master Precertification List (For Health Care Providers) |
| Cigna | Basic Standard | All | prior auth required | May be delegated to eviCore for some clients | Oct 1, 2006 | Master Precertification List (For Health Care Providers) |
| Cigna | Complete/PHS+/Preferred | All | prior auth required | May be delegated to eviCore for some clients | Oct 1, 2006 | Master Precertification List (For Health Care Providers) |
| Cigna | Other Services | All | prior auth required | Experimental/investigational | Mar 7, 2026 | Cigna Commercial Comprehensive CPT Code Reference for Prior Authorization Across All Programs |
| Cigna | Other Services | All | prior auth required | Experimental/investigational | Mar 7, 2026 | Cigna Commercial Prior Authorization Procedure Code List: Other Services |
| Blue Cross and Blue Shield of Texas | Texas PA exemption (gold card), outpatient, fully insured | TX | prior auth required | Gold-card exemption available | Jul 1, 2026 | BCBSTX Outpatient Prior Authorization Exemption Clinical Guidelines (max units, PA exempt date range) |
| HealthSpring | Medicare Advantage | All | prior auth required | Jan 1, 2025 | 2026 Q4 Prior Authorization List | |
| Humana | Oak Street Health | All | prior auth required | Oak Street Health (Humana): Prior Authorization List (PAL) Codes Under Management | ||
| Molina Complete Care (Virginia) | Medicare-only PA matrix for D-SNP | VA | prior auth required | Jan 1, 2022 | Medicare Prior Auth (PA) Code Matrix (Virginia), effective Q1 2022 | |
| Molina Healthcare of Arizona | Medicare-only PA matrix for D-SNP | AZ | prior auth required | Jan 1, 2022 | Medicare Prior Auth (PA) Code Matrix (Arizona), effective Q1 2022 | |
| Molina Healthcare of California | Medicare Advantage | CA | prior auth required | Jul 1, 2021 | Medicare Prior Auth (PA) Code Matrix (California), effective Q3 2021 | |
| Molina Healthcare of Florida | Medicare Advantage | FL | prior auth required | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Florida), effective Q2 2021 | |
| Molina Healthcare of Idaho | Medicare Advantage | ID | prior auth required | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Idaho), effective Q2 2021 | |
| Molina Healthcare of Iowa | Medicaid | IA | prior auth required | Jul 1, 2023 | IA Prior Authorization Matrix, effective Q3 2023 | |
| Molina Healthcare of Michigan | Exchange | MI | prior auth required | Jul 1, 2021 | Molina Healthcare of Michigan PA Matrix, effective 7/1/2021 | |
| Molina Healthcare of Nevada | Medicaid | NV | prior auth required | Oct 1, 2022 | Medicaid Prior Auth (PA) Code Matrix, effective Q4 2022 | |
| Molina Healthcare of New Mexico | Medicare Advantage | NM | prior auth required | Jan 1, 2021 | Medicare Prior Auth (PA) Code Matrix (New Mexico), effective Q1 2021 | |
| Molina Healthcare of Ohio | Medicaid and MyCare Ohio (MMP) Medicaid | OH | prior auth required | Oct 1, 2023 | Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01 | |
| Molina Healthcare of Ohio | Medicare and MyCare Ohio (MMP) Medicare | OH | prior auth required | Oct 1, 2023 | Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01 | |
| Molina Healthcare of Ohio | Exchange | OH | prior auth required | Oct 1, 2023 | Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01 | |
| Molina Healthcare of South Carolina | Medicare Advantage | SC | prior auth required | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (South Carolina), effective Q2 2021 | |
| Molina Healthcare of Texas | Exchange | TX | prior auth required | Sep 1, 2019 | Marketplace Prior Authorization (PA) Code Matrix (Texas), effective July 1, 2026 | |
| Molina Healthcare of Utah | Medicare Advantage | UT | prior auth required | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Utah), effective Q2 2021 | |
| Molina Healthcare of Washington | Medicare Advantage | WA | prior auth required | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Washington), effective Q2 2021 | |
| Molina Healthcare of Wisconsin | Medicare Advantage | WI | prior auth required | Oct 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Wisconsin), effective Q4 2021 | |
| Molina Healthcare, Inc. (national grid) | Molina national (MHI) Medicare grid | All | prior auth required | Oct 1, 2021 | Medicare Prior Auth (PA) Code Matrix (national), effective Q4 2021 | |
| Oxford Health Plans | Oxford Health Plans | All | prior auth required | Oct 1, 2026 | Prior Authorization Requirements for Oxford Effective October 1, 2026 | |
| UnitedHealthcare | Preferred Care Network and Preferred Care Partners of Florida | FL | prior auth required | Oct 1, 2026 | Prior authorization requirements for Preferred Care Network and Preferred Care Partners of Florida Effective October 1, 2026 | |
| UnitedHealthcare | UnitedHealthcare Complete (Individual & Family plans) | All | prior auth required | Sep 1, 2026 | Prior authorization requirements for UnitedHealthcare Complete Effective September 1, 2026 | |
| UnitedHealthcare | UnitedHealthcare Individual Exchange plans | All | prior auth required | Oct 1, 2026 | Prior authorization requirements for UnitedHealthcare Individual Exchange plans Effective October 1, 2026 | |
| UnitedHealthcare | UnitedHealthcare Medicare Advantage, Peoples Health and Dual Complete (D-SNP) | All | prior auth required | Oct 1, 2026 | UnitedHealthcare® Medicare Advantage/ Peoples Health Plans prior authorization requirements Effective October 1, 2026 | |
| UnitedHealthcare Community Plan | Minnesota Metro Medicaid | MN | prior auth required | Oct 1, 2024 | Prior authorization requirements for Minnesota Medicaid Effective October 1, 2024 | |
| UnitedHealthcare Community Plan | UnitedHealthcare Connected (Texas MMP) | TX | prior auth required | Jul 1, 2021 | Prior authorization requirements for UnitedHealthcare Connected (Medicare-Medicaid Plan) Texas Effective November 1, 2025 This list contains prior authorization review requirements for participating U |
31299 appears in 36 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island, Blue Cross NC, Blue Shield of California, BlueCross BlueShield of South Carolina, Cigna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, Regence, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Tezepelumab-ekko (Tezspire) (1003) | listed, no stance (range 30000-31299) | Aug 6, 2026 | payer document |
| Anthem | Drug-Eluting Devices for Maintaining Sinus Ostial Patency (SURG.00132) | unproven / investigational | Feb 19, 2026 | payer document |
| Anthem | Self-Expanding Absorptive Sinus Ostial Dilation (SURG.00089) | unproven / investigational | Feb 19, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Cryoablation Radiofrequency Ablation And Laser Ablation For Treatment Of Chronic Rhinitis (A.7.01.168) | unproven / investigational | payer document | |
| Blue Cross & Blue Shield of Mississippi | Steroideluting Sinus Stents And Implants (A.7.01.134) | unproven / investigational | payer document | |
| Blue Cross & Blue Shield of Rhode Island | Cryoablation, Radiofrequency Ablation, and Laser Ablation for Treatment of Chronic Rhinitis | not covered | Mar 18, 2026 | payer document |
| Blue Cross NC | Cryoablation, Radiofrequency Ablation, and Laser Ablation for Treatment of Chronic Rhinitis | listed, no stance | Aug 1, 2026 | payer document |
| Blue Cross NC | Professional Pathology Billing Requirements AHS – R2169 | listed, no stance (range 3011F-3210F) | Mar 1, 2024 | payer document |
| Blue Cross NC | Surgical Treatment of Sinus Disease | listed, no stance | Feb 1, 2026 | payer document |
| Blue Shield of California | Balloon Ostial Dilation for Treatment of Chronic and Recurrent Acute Rhinosinusitis (7.01.105) | listed, no stance | payer document | |
| Blue Shield of California | Cryoablation, Radiofrequency Ablation, and Laser Ablation for Treatment of Chronic Rhinitis (7.01.168) | listed, no stance | payer document | |
| Blue Shield of California | Steroid-Eluting Sinus Stents and Implants (7.01.134) | listed, no stance | payer document | |
| BlueCross BlueShield of South Carolina | Balloon Ostial Dilation for Treatment of Chronic and Recurrent Acute Rhinosinusitis (CAM 701105) | listed, no stance | Sep 1, 2025 | payer document |
| BlueCross BlueShield of South Carolina | Steroid-Eluting Sinus Stents and Implants (CAM 701134) | listed, no stance | Aug 1, 2026 | payer document |
| Cigna | Bone Graft Substitutes (0118) | listed, no stance | Feb 15, 2026 | payer document |
| Cigna | Drug-Eluting Devices for Use Following Endoscopic Sinus Surgery (0481) | unproven / investigational | Apr 15, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Cryoablation, Radiofrequency Ablation, and Laser Ablation for Treatment of Chronic Rhinitis (SUR706.020) | listed, no stance | Jun 15, 2025 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Drug-Eluting Sinus Implants (SUR706.021) | listed, no stance | Jan 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Medical Policies Moving to MCG Guidelines Sinus Surgery | 30400, 30410, 30420, 30430, | Rhinoplasty | listed, no stance | Jan 1, 2026 | payer document |
| Premera Blue Cross | Steroid-Eluting Sinus Stents and Implants (7.01.134) | listed, no stance | Oct 14, 2026 | payer document |
| Regence | Ablation for the Treatment of Chronic Rhinitis (Surgery 224) | listed, no stance | Dec 1, 2025 | payer document |
| Regence | Balloon Ostial Dilation for Treatment of Sinusitis (Surgery 153) | listed, no stance | Oct 1, 2025 | payer document |
| Regence | Implantable Sinus Devices for Postoperative Use Following Endoscopic Sinus Surgery and for Recurrent Sinonasal Polyposis (Surgery 198) | listed, no stance | Aug 1, 2025 | payer document |
| UnitedHealthcare | Ear, Nose, and Throat Procedures (MMP060.17) Balloon Sinus Ostial Dilation (Also Known as Balloon Dilation Sinuplasty) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Sinus Surgeries and Interventions (2026T0571U) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Sinus Surgeries and Interventions (CS138.T) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Sinus Surgeries and Interventions (for Idaho Only) (CS138ID.D) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Sinus Surgeries and Interventions (for Kansas Only) (CS138KS.03) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Sinus Surgeries and Interventions (for Kentucky Only) (CS138KY.13) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Sinus Surgeries and Interventions (for Nebraska Only) (CS138NE.U) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Sinus Surgeries and Interventions (for New Jersey Only) (CS138NJ.O) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Sinus Surgeries and Interventions (for New Mexico Only) (CS138NM.D) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Sinus Surgeries and Interventions (for North Carolina Only) (CSNCT0571.06) | listed, no stance | Aug 1, 2025 | payer document |
| UnitedHealthcare | Sinus Surgeries and Interventions (for Ohio Only) (CS138OH.D) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Sinus Surgeries and Interventions (for Pennsylvania Only) (CS138PA.Q) | listed, no stance | Aug 1, 2025 | payer document |
| UnitedHealthcare | Sinus Surgeries and Interventions (for Tennessee Only) (CS138TN.Q) | listed, no stance | Aug 1, 2026 | payer document |
Prior authorization required or conditional in FL, KY, VT, WV, WY.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.