How To Use CPT Code 31254

CPT 31254 describes a specific endoscopic procedure performed on the nasal and sinus cavities. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 31254?

CPT 31254 is a code used to describe a surgical procedure involving the nasal and sinus cavities. This procedure, known as partial anterior ethmoidectomy, involves the removal of certain structures within the ethmoid sinus to improve the patient’s condition. It is important to note that CPT 31254 should not be reported in conjunction with specific other codes that are performed on the same side.

2. Official Description

The official description of CPT code 31254 is: ‘Nasal/sinus endoscopy, surgical with ethmoidectomy; partial (anterior).’ It is important to remember not to report this code with certain other codes that are performed on the same side.

3. Procedure

1. The procedure begins with the administration of anesthesia to the patient.
2. A rigid or flexible endoscope is then inserted into the nasal cavity to provide visualization.
3. The surgeon identifies the ethmoid bulla, which is an air pocket surrounded by bone.
4. The ethmoid bulla is opened and resected using cutting forceps, allowing for a clear view of the nasal lamella and retrobulbar space.
5. The anterior cells within the ethmoid sinus are opened and partially removed.
6. Finally, the incision is closed, and the endoscope is removed.

4. Qualifying circumstances

CPT 31254 is typically performed on patients who require surgical intervention for conditions affecting the nasal and sinus cavities. This procedure specifically targets the ethmoid sinus and is used to address certain issues, such as chronic sinusitis or nasal polyps. It is important to note that CPT 31254 should not be reported in conjunction with specific other codes that are performed on the same side.

5. When to use CPT code 31254

CPT code 31254 should be used when a partial anterior ethmoidectomy is performed as a surgical procedure on the nasal and sinus cavities. It is important to ensure that the procedure is not performed in conjunction with specific other codes that are performed on the same side.

6. Documentation requirements

To support a claim for CPT 31254, the following documentation should be included:

• Clear indication of the patient’s diagnosis and the medical necessity for the procedure
• Detailed description of the procedure performed, including the specific structures targeted and the extent of the ethmoidectomy
• Date of the procedure
• Any additional relevant information, such as complications or unexpected findings
• Signature of the performing surgeon

7. Billing guidelines

When billing for CPT 31254, it is important to ensure that the procedure is not reported in conjunction with specific other codes that are performed on the same side. Additionally, it is crucial to follow any specific guidelines provided by the payer regarding documentation and coding for this procedure.

8. Historical information

CPT code 31254 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2018, with the updated description being ‘Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial (anterior).’ No further updates have been made to the code since then.

9. Examples

1. A patient with chronic sinusitis undergoes a partial anterior ethmoidectomy to alleviate symptoms and improve sinus drainage.
2. A surgeon performs a partial anterior ethmoidectomy on a patient with nasal polyps to remove the affected tissue and improve breathing.
3. An individual with recurrent sinus infections undergoes a partial anterior ethmoidectomy to address the underlying cause and reduce the frequency of infections.
4. A patient with a history of ethmoid sinusitis undergoes a partial anterior ethmoidectomy to remove diseased tissue and prevent further complications.
5. A surgeon performs a partial anterior ethmoidectomy on a patient with a deviated nasal septum to improve airflow and alleviate symptoms.
6. An individual with chronic rhinosinusitis undergoes a partial anterior ethmoidectomy to address the underlying inflammation and improve sinus function.
7. A patient with nasal polyps and chronic sinusitis undergoes a partial anterior ethmoidectomy to remove the polyps and alleviate symptoms.
8. A surgeon performs a partial anterior ethmoidectomy on a patient with a mucocele to remove the cyst and prevent further complications.
9. An individual with recurrent sinus infections and nasal congestion undergoes a partial anterior ethmoidectomy to improve sinus drainage and alleviate symptoms.
10. A patient with ethmoid sinusitis and facial pain undergoes a partial anterior ethmoidectomy to address the underlying cause and alleviate discomfort.