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Nasal/sinus endoscopy, surgical, with dilation (CPT® Code 31297) refers to a minimally invasive procedure aimed at treating chronic sinusitis characterized by obstruction of the sphenoid sinus ostium, which is the opening of the sphenoid sinus. This procedure involves the use of an endoscope, a thin, flexible tube equipped with a camera and light, allowing the physician to visualize the internal structures of the nasal passages and sinuses. The primary goal of the endoscopic dilation is to restore normal drainage of the affected sinus by widening the ostium. This is achieved through the inflation of a small balloon that compresses the surrounding mucosa and displaces bony structures, effectively enlarging the opening. Prior to the procedure, a topical nasal decongestant and local anesthetic with a vasoconstrictor may be applied to minimize discomfort and reduce bleeding. The endoscope is carefully introduced through the nostril and navigated to the sphenoid sinus, where the balloon dilation is performed. This technique is particularly beneficial for patients suffering from chronic sinusitis, as it alleviates symptoms by improving sinus drainage and reducing inflammation.
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The procedure is indicated for patients suffering from chronic sinusitis with obstruction of the sphenoid sinus ostium. This condition often leads to persistent symptoms such as nasal congestion, facial pain, and pressure, which can significantly impact the quality of life. The dilation of the sphenoid sinus ostium aims to alleviate these symptoms by restoring normal sinus drainage.
The procedure begins with the application of a topical nasal decongestant and local anesthetic with a vasoconstrictor to minimize discomfort and reduce bleeding during the endoscopic intervention. Following this, the physician introduces an endoscope through the nostril and carefully advances it to the affected sphenoid sinus. Once the endoscope is in place, a guidewire catheter equipped with a small balloon is inserted and navigated to the ostium of the blocked sinus. The balloon is then inflated, which compresses the surrounding mucosa and displaces bony structures, effectively widening the ostium. This inflation is followed by deflation, and the process is repeated as necessary until the ostium is adequately dilated. Throughout the procedure, the physician inspects the ostium using the endoscope to ensure that the dilation is sufficient. Once the desired dilation is achieved, the endoscope is removed, completing the procedure.
After the procedure, patients may experience some discomfort, nasal congestion, or minor bleeding, which are typically expected and resolve on their own. It is important for patients to follow any post-operative care instructions provided by their physician, which may include the use of saline nasal sprays to keep the nasal passages moist and promote healing. Patients should also be advised to avoid strenuous activities and heavy lifting for a short period following the procedure to minimize the risk of complications. Follow-up appointments may be scheduled to monitor recovery and assess the effectiveness of the dilation in relieving symptoms.
| Short Descr | NSL/SINS NDSC SURG SPHN SINS | Medium Descr | NASAL/SINUS NDSC SURG W/DILATION SPHENOID SINUS | Long Descr | Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); sphenoid sinus ostium | 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) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - 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 | Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P8I - Endoscopy - other | MUE | 1 | CCS Clinical Classification | 33 - Other OR therapeutic procedures on nose, mouth and pharynx |
| 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). | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | RT | Right side (used to identify procedures performed on the right side of the body) | LT | Left side (used to identify procedures performed on the left side of the body) | 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. | 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. | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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 | SG | Ambulatory surgical center (asc) facility service | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2020-01-01 | Changed | Code description changed. |
| 2018-01-01 | Changed | AMA guideline changed. |
| 2011-01-01 | Added | Added |
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