Chapter 5 / Ear, nose and throat

Septorhinoplasty is only eligible under certain limited circumstances for restoration of normal appearance
immediately after trauma/tumour. The presence of nasal obstruction does not make a septorhinoplasty
eligible for benefit. We request that all such procedures are preauthorised to avoid disappointment to
policyholders.


Uvulopalatoplasty is not included in our schedule and is not eligible under any circumstances for
treatment of sleep apnoea.


FESS includes removal of nasal polyps, antrostomy and turbinate reduction and these should not be
charged as extra.


Codes designed for use in theatre should not be used in the out-patient setting, for example nasal
cautery or removal of foreign body from nose.


Packing of the nose should not be charged as extra with nasal surgery.

The code for Epley manoeuvre is soley for use by specialists and practitioners. Where a member has an appointment specifically to undertake the Epley manoeuvre we do not expect to receive a consultation charge. We do not expect to receive any charges from hospitals or facilities for this service unless they are billing on behalf of the service provider.




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