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Clarification of 31256

  1. #1
    Default Clarification of 31256
    Medical Coding Books
    I would just like someone else's input on the description of this CPT. The way I am interpreting this is that polyp removal is included in 31256. 31267 is for removal of diseased antral mucosa. The ENT's office has been using 31267 for removal of polyps with antrostomy. Any help is greatly appreciated.
    The following is the description from ASCExpert; A scalpel or biting forceps is introduced parallel to the endoscope and is used to remove diseased tissues. Polyps may be excised. An antrostomy is performed in 31256, creating an opening for drainage from the maxillary sinus. Additionally, in 31267, the maxillary sinus may be opened and the mucosa removed. In either case, electrocautery may be used for hemostasis.

  2. #2
    I think 31256 can include polyp removal with the antrostomy - the notes in the CPT between 31256 and 31267 provide some clues that the code descriptors are missing (even though they don't exactly apply to the procedure in question). They're both instructions on coding endoscopic ethmoidectomy, with antrostomy, with or without removal of polyps, but one specifies that removal of antral mucosal disease is also performed. The code with instruction to report 31256 (with 31255 for the irrelevant portion of the procedure) includes only the antrostomy, with or without polyp removal. I think that if no antral mucosal disease is excised, 31267 is not the correct code, based on those notes.

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