US Reimbursement Resources

US Reimbursement Resources

We understand the importance of tools and education in helping you navigate through the complex ENT reimbursement environment. The resources below contain valuable information on ENT coding, reimbursement and procedure documentation

purple map of Unites States

Commercial ETBD Insurance Policy Dashboard for Healthcare Professionals

While access to care has improved, coverage policies and criteria for Eustachian Tube Balloon Dilation, ETBD, vary across commercial plans.  This proprietary tool curates publicly available health plan information to track ETBD policy changes and coverage*.

Coding, Coverage Reimbursement and Documentation Resources

Acclarent Reimbursement Guide for Physician and Facilities 

This guide has been developed to assist you in obtaining appropriate physician payment and hospital facility reimbursement for Nasal/Sinus Endoscopic Surgery, Eustachian Tube Balloon Dilation, Airway Dilation, and Computer Assisted Navigation procedures.

Acclarent ENT Medicare Updates

This update reflects the current Medicare national average fee schedules for Physician, Hospital Outpatient and Ambulatory Surgery Centers, for Balloon Sinuplasty (BSP), Eustachian Tube Balloon Dilation (ETBD), Airway Dilation, and Navigation procedures.

FAQ Acclarent Coding and Reimbursement for Physician and Facilities

Get the answers to commonly asked reimbursement and coding questions. Use the table of contents to easily find relevant topics, including prior approval, place of service, coding, modifiers and more.

Acclarent HCPCS Guide

This guide has been developed to assist in locating the appropriate HCPCS codes for Acclarent products used in the hospital outpatient setting.

FOR ADDITIONAL QUESTIONS OR INFORMATION CONTACT:  
[email protected] 877.340.6466 

CPT® codes and descriptors copyright ©2019 American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association. 
Disclaimer: The information is provided to assist you in understanding the reimbursement process. It is intended to assist providers in accurately obtaining reimbursement for health care services. It is not intended to increase or maximize reimbursement by any payer. We strongly suggest that you consult your payer organization with regard to local reimbursement policies. The information contained in this document is provided for information purposes only and represents no statement, promise or guarantee by Acclarent, Inc. concerning levels of reimbursement, payment or charge. Similarly, all CPT® & HCPCS codes are supplied for information purposes only and represent no statement; promise or guarantee by Acclarent, Inc. that these codes will be appropriate or that reimbursement will be made. 

The third-party trademarks used herein are trademarks of their respective owners. 

References 

*The information provided is based on analysis of data aggregated from one or more data sources and does not represent any statement, promise or guarantee by Johnson & Johnson MedTech (“JJMT”) concerning costs, clinical outcomes or data accuracy.  Always check with your insurance provider regarding up-to-date coverage information. The information should be carefully considered along with clinical experience, treatment patterns and other factors pertaining to the specific institution or patients. The information being provided is not a substitute for clinical judgment, and neither JJMT nor any other party involved in the preparation or publication of this information shall be liable to you or others for any decisions made or action taken by you or others in reliance on this information.  A positive coverage policy does not ensure coverage.  It is strongly recommended that the provider reach out to the applicable payer to verify benefits and verify any payer specific requirements for pre-authorization and billing prior to providing any services and filing any claims for payment. 

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Disclosures 

Acclarent Navigation Technology is intended for use by or under the direction of a physician. Devices guided by the Acclarent Navigation Technology have described risks including the potential for unintended injury to the orbits or CNS as a consequence of inaccurate navigation. 

ACCLARENT AERA® Eustachian Tube Balloon Dilation System is intended for use by physicians who are trained on Acclarent Technology. Eustachian tube balloon dilation has associated risks, including tissue and mucosal trauma, infection, or possible carotid artery injury. 

ACCLARENT® Balloon Sinuplasty Devices are intended for use by or under the direction of a physician who is trained in the use of Acclarent Technology. ACCLARENT® Balloon Sinuplasty Device use has described risks, including tissue and mucosal trauma, infection, or possible orbital injury. 

The RELIEVA TRACT™ Nasal Balloon Dilation System is an instrument intended to provide increased intranasal space to facilitate access for endonasal and trans-nasal procedures and/or temporarily address nasal obstruction by displacing the inferior turbinate and lower nasal septum. The RELIEVA TRACT™ Nasal Balloon Dilation System is intended for use in ages 17 years or older. Balloon dilation catheters should be used by or under supervision of physicians thoroughly trained in balloon dilation. A thorough understanding of the technical principles, clinical application, and risk associated with balloon dilation of the nasal passage is necessary before using this device. 

Important Safety Information 

The RELIEVA SPINPLUS® NAV Balloon Sinuplasty System is intended to provide a means to access the sinus space, within and across nasal and sinus structures; dilate the sinus ostia and spaces associated with the paranasal sinus cavities for diagnostic and therapeutic procedures; and irrigate from within a target sinus for therapeutic procedures and to facilitate diagnostic procedures. For children aged 17 and under, the RELIEVA SPINPLUS® NAV Balloon Sinuplasty System is intended to provide a means to access the sinus space, within and across nasal and sinus structures; dilate sinus ostia and spaces associated with the maxillary sinus for diagnostic and therapeutic procedures; and irrigate from within the maxillary sinus for therapeutic procedures and to facilitate diagnostic procedures. Acclarent Navigation Technology is intended for use by or under the direction of a physician. Devices guided by the Acclarent Navigation Technology have described risks including the potential for unintended injury to the orbits or CNS as a consequence of inaccurate navigation. Prior to use, it is important to read the Instructions for Use and to understand the registration process and the contraindications, warnings and precautions described for the system. 

Prior to use, it is important to read the Instructions for Use and to understand the registration process and the contraindications, warnings and precautions described for the systems. 

Caution: Federal (US) law restricts the sale, distribution or use of these devices to, by or on the order of a physician. Third party trademarks used herein are trademarks of their respective owners. This content is intended for audience within the US only. 
This site is published by Acclarent, Inc. which is solely responsible for its contents. It is intended for visitors from the United States. 

© Acclarent, Inc. 2022. Last Updated on 10/28/2022