Wiki CPT 31276: Frontal sinus exploration

[Stacey Walden]

Clarification please. A patient has complete opacification of the frontal sinuses bilaterally but the physician is uncertain if removal of tissue is required on both sides. If removal of tissue is required on the left frontal sinus but no tissue removal is required on the right do we still bill 31276 with a 50 modifier?

CPT 31276: Nasal/sinus endoscopy, with frontal sinus exploration, including removal of tissue from the frontal sinus, when performed
Additional information shows that CPT 31276 is described from tools like the Coder’s Desk Reference or Encoder Pro, as making a “sinusotomy” into the frontal sinus (opening up the frontal sinus) and that the intent of CPT 31276 is to open up the sinus to help it drain more effectively and to have a look around but there is no requirement that the surgeon has to remove tissue from the frontal sinus to receive credit for this code.

Is this accurate?

 

[cpc2007]

Hi Stacey, yes, agree with your assessment here. As long as as sinusotomy was performed on both sides, even if no tissue like polyps or inflammed mucosa were removed on that right side, you can still bill 31276 with modifier 50. The phrase "when performed" after including removal of tissue from the frontal sinus confirms that you cannot code a separate CPT for any tissue removed in the frontal sinus (it is included in 31276 when tissue removal occurs), but tissue removal is not a requirement to report the code.

I hope that helps

Kim
www.codingmastery.com