will apply to all services performed on or after the above Revision date which
will become the new effective date.
services referred to in this policy that were performed before the revision
date, contact customer service for the rules that would apply.
Rhinoplasty is a surgical procedure to reshape the contour and shape of the
nose. When rhinoplasty is performed primarily to change the appearance of the
nose, it is considered cosmetic, and is not covered. See the Cosmetic Surgery
Septoplasty is a
procedure to move or realign a deviated nasal septum to help to clear the
breathing in one nostril that is blocked. This procedure is covered.
When both Rhinoplasty and
Septoplasty are performed together, QualChoice will require an operation report
and other medical records, which will be reviewed to determine the medical
necessity of the procedure.