I am having trouble coding a FESS procedure with these new sinus codes. I just can't wrap my head around it sometimes. My physician did a Bilateral Balloon Sinuplasty (with removal of bone/tissue) along with a Right Total Ethmoidectomy, and Right Sphenoidotomy. Would I do 31253-RT, 31276-59LT, 31287-59RT? Because the Total Ethmoid and Sphenoid are both Right sided I am stumped! We are also hospital owned so those coders don't agree with me that you shouldn't code 31253 and 31257 at the same time unless they are opposite sides. Sigh.....Anyone help me out?