© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 31242 involves a surgical nasal and sinus endoscopy that specifically targets the destruction of the posterior nasal nerve (PNN) using radiofrequency ablation. This intervention is primarily indicated for patients suffering from chronic rhinorrhea, which is characterized by excessive mucus production due to a hyperactive PNN. This condition is often referred to as intractable vasomotor rhinitis. The goal of the procedure is to denervate the mucosa, thereby alleviating the nasal symptoms associated with this condition. During the procedure, a small endoscopic camera is utilized to provide visualization of the nasal passages, allowing for precise intervention. Local anesthesia is administered through the application of surgical cotton wads soaked in a decongestant and anesthetic, which are placed in various areas of the nasal cavity to ensure patient comfort. Following this, an intranasal anesthetic and vasoconstrictive agent are injected to further enhance the anesthetic effect. The procedure involves the introduction of a radiofrequency delivery device, which is designed to fit into the sphenopalatine regions and the inferior turbinate. This device applies low power radiofrequency energy to disrupt the nerve by generating heat in the targeted mucosal areas at the back of the nose. After the procedure is completed on one side, the instruments are removed, and the same steps are repeated on the opposite side to ensure comprehensive treatment.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 31242 is indicated for the treatment of chronic rhinorrhea, which is a condition characterized by excessive nasal mucus production. This condition is often caused by a hyperactive posterior nasal nerve (PNN), leading to symptoms associated with intractable vasomotor rhinitis. The procedure aims to alleviate these symptoms by targeting and disrupting the nerve responsible for the overproduction of mucus.
The procedure begins with the insertion of a small nasal endoscopic camera, which allows the physician to visualize the nasal passages and identify the areas requiring treatment. Following visualization, local anesthesia is administered to ensure patient comfort during the procedure. This is achieved by packing wads of surgical cotton soaked in a decongestant and anesthetic into various regions of the nasal cavity, such as the back of the middle meatus and the side of the middle turbinate. The cotton is left in place for a period to allow the anesthetic to take effect. Subsequently, an intranasal anesthetic and a vasoconstrictive agent are injected to further enhance the numbing effect and reduce blood flow to the area, facilitating a clearer view and minimizing bleeding during the procedure.
After the completion of the procedure, patients may experience some discomfort or nasal congestion as a result of the intervention. It is important for healthcare providers to monitor the patient for any immediate complications. Patients are typically advised on post-procedure care, which may include the use of saline nasal sprays to keep the nasal passages moist and to promote healing. Follow-up appointments may be scheduled to assess the effectiveness of the procedure and to manage any ongoing symptoms. Patients should be informed about potential side effects, such as temporary nasal discomfort or changes in nasal drainage, and instructed to report any unusual symptoms to their healthcare provider.
| Short Descr | NSL/SINUS NDSC RF ABLTJ PNN | Medium Descr | NASAL/SINUS NDSC DSTRJ RF ABLATION PST NSL NRV | Long Descr | Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 3 - Special payment adjustment rules for multiple endoscopic procedures apply. | Bilateral Surgery (50) | 2 - 150% payment adjustment does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Endoscopic Base Code | 31231 Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure) | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2024-01-01 | Added | Code Added. |
Get instant expert-level medical coding assistance.