Understanding Endoscopic Sinus Surgery CPT Codes

Endoscopic sinus surgery is a minimally invasive procedure performed to treat various sinus conditions, including chronic sinusitis, nasal polyps, and sinus tumors. To ensure accurate documentation and appropriate billing, the American Medical Association (AMA) has established Current Procedural Terminology (CPT) codes for different aspects of endoscopic sinus surgery. In this article, we will explore the key endoscopic sinus surgery CPT codes, along with code descriptions, and coding guidelines.

Understanding Endoscopic Sinus Surgery CPT Codes

1. CPT Code 31241: Nasal/Sinus Endoscopy with Ligation of Sphenopalatine Artery

This code is used when performing a nasal/sinus endoscopy with the ligation of the sphenopalatine artery. Do not report this code in conjunction with 31238 when performed on the same side.

2. CPT Code 31254: Nasal/Sinus Endoscopy with Partial Ethmoidectomy (Anterior)

This code is utilized for surgical endoscopy of the nasal/sinus cavity, along with a partial ethmoidectomy of the anterior ethmoid sinus. Do not report this code in conjunction with 31253, 31255, 31257, 31259, 0406T, or 0407T when performed on the same side.

3. CPT Code 31255: Nasal/Sinus Endoscopy with Total Ethmoidectomy (Anterior and Posterior)

This code is used for surgical endoscopy of the nasal/sinus cavity, along with a total ethmoidectomy involving both the anterior and posterior ethmoid sinuses. Do not report this code in conjunction with 31253, 31254, 31257, 31259, 31276, 31287, 31288, 0406T, or 0407T when performed on the same side.

4. CPT Code 31253: Nasal/Sinus Endoscopy with Total Ethmoidectomy (Anterior and Posterior) and Frontal Sinus Exploration

This code is employed for surgical endoscopy of the nasal/sinus cavity, including a total ethmoidectomy with both anterior and posterior involvement, as well as frontal sinus exploration with the removal of tissue from the frontal sinus. Do not report this code in conjunction with 31237, 31254, 31255, 31276, 31296, 31298, 0406T, or 0407T when performed on the same side.

5. CPT Code 31257: Nasal/Sinus Endoscopy with Total Ethmoidectomy (Anterior and Posterior) and Sphenoidotomy

This code is used for surgical endoscopy of the nasal/sinus cavity, including a total ethmoidectomy with both anterior and posterior involvement, as well as a sphenoidotomy. Do not report this code in conjunction with 31235, 31237, 31254, 31255, 31259, 31287, 31288, 31297, 31298, 0406T, or 0407T when performed on the same side.

6. CPT Code 31259: Nasal/Sinus Endoscopy with Total Ethmoidectomy (Anterior and Posterior), Sphenoidotomy, and Removal of Tissue from Sphenoid Sinus

This code is utilized for surgical endoscopy of the nasal/sinus cavity, including a total ethmoidectomy with both anterior and posterior involvement, a sphenoidotomy, and the removal of tissue from the sphenoid sinus. Do not report this code in conjunction with 31235, 31237, 31254, 31255, 31257, 31287, 31288, 31297, 31298, 0406T, or 0407T when performed on the same side.

7. CPT Code 31256: Nasal/Sinus Endoscopy with Maxillary Antrostomy

This code is used when performing endoscopic anterior and posterior ethmoidectomy (APE) and antrostomy, with or without the removal of polyps. For endoscopic APE, antrostomy, and removal of antral mucosal disease, use 31255 and 31267.

8. CPT Code 31267: Nasal/Sinus Endoscopy with Maxillary Antrostomy and Removal of Tissue from Maxillary Sinus

This code is employed for endoscopic anterior and posterior ethmoidectomy (APE) and maxillary antrostomy, with the removal of tissue from the maxillary sinus. Do not report this code in conjunction with 31256 or 31295 when performed on the same sinus.

9. CPT Code 31276: Nasal/Sinus Endoscopy with Frontal Sinus Exploration, including Removal of Tissue from Frontal Sinus

This code is used for surgical endoscopy of the nasal/sinus cavity, including frontal sinus exploration and the removal of tissue from the frontal sinus. Do not report this code in conjunction with 31253, 31255, 31296, or 31298 when performed on the same side.

10.CPT Codes 31287: Nasal/Sinus Endoscopy, Surgical, with Sphenoidotomy and CPT Codes 31288: Nasal/sinus Endoscopy, Surgical, with Sphenoidotomy; with Removal of Tissue from the Sphenoid Sinus

These codes are utilized for surgical endoscopy of the nasal/sinus cavity, including a sphenoidotomy. Do not report 31287 in conjunction with 31235, 31255, 31257, 31259, 31288, 31297, or 31298 when performed on the same side. Similarly, do not report 31288 in conjunction with 31235, 31255, 31257, 31259, 31287, 31297, or 31298 when performed on the same side.

A detailed understanding of the endoscopic sinus surgery CPT codes is essential for proper documentation, avoid claim denials, and timely insurance reimbursement. The provided codes cover a range of procedures involving different sinuses and tissue removal. Adhering to the guidelines and accurately documenting the performed procedures will ensure appropriate reporting and facilitate efficient communication among healthcare providers and insurance entities.

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