How To Use CPT Code 31293

CPT 31293 describes a surgical procedure involving nasal/sinus endoscopy with orbital decompression of the medial and inferior walls. 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 31293?

CPT 31293 is a code used to describe a surgical procedure that involves the use of an endoscope to perform nasal/sinus endoscopy with orbital decompression of the medial and inferior walls. This procedure is performed to relieve pressure and decompress the orbital walls, specifically the medial wall closest to the nose and the inferior wall which forms the floor of the orbit.

2. Official Description

The official description of CPT code 31293 is: ‘Nasal/sinus endoscopy, surgical, with orbital decompression; medial and inferior wall.’ It is important to note that this code should not be reported in conjunction with other specific codes when performed on the same side.

3. Procedure

1. The patient is appropriately prepped and anesthetized for the procedure.
2. The healthcare provider performs nasal endoscopy using a rigid or flexible endoscope.
3. The provider inspects the nasal cavity and paranasal sinuses for any disease or abnormalities.
4. The ethmoidal sinuses are cleared, and the medial orbital wall is exposed.
5. Elevators are used to open the medial orbital wall for decompression.
6. The lamina papyracea, which separates the orbit from the ethmoidal sinuses, is removed to allow the contents of the orbit to shift into the ethmoid region.
7. The provider then proceeds to decompress the inferior orbital wall, approaching it through the maxillary sinus.
8. If bleeding occurs, the provider may pack the nose after the procedure.

4. Qualifying circumstances

CPT 31293 is performed on patients who require decompression of both the medial and inferior orbital walls. It is important to note that this code should not be reported in conjunction with specific codes when performed on the same side.

5. When to use CPT code 31293

CPT code 31293 should be used when a healthcare provider performs nasal/sinus endoscopy with orbital decompression of the medial and inferior walls. It is important to ensure that the procedure involves decompression of both walls and not just one. This code should not be reported in conjunction with specific codes when performed on the same side.

6. Documentation requirements

To support a claim for CPT code 31293, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for orbital decompression
• Details of the procedure, including the use of an endoscope and the specific walls decompressed
• Date and duration of the procedure
• Any complications or additional interventions performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 31293, ensure that the procedure involves the decompression of both the medial and inferior orbital walls. It is important not to report this code in conjunction with specific codes when performed on the same side. Additional tips for accurate billing can be obtained from the official coding guidelines and resources.

8. Historical information

CPT code 31293 was added to the Current Procedural Terminology system on January 1, 1994. The code underwent a change on January 1, 2020, with an updated description that includes specific details about the decompression of the medial and inferior orbital walls.

9. Examples

1. A patient undergoes nasal/sinus endoscopy with orbital decompression of the medial and inferior walls to relieve pressure caused by Graves’ disease.
2. A healthcare provider performs nasal/sinus endoscopy with orbital decompression of the medial and inferior walls to alleviate symptoms of orbital cellulitis in a patient.
3. A patient with chronic sinusitis undergoes nasal/sinus endoscopy with orbital decompression of the medial and inferior walls to improve sinus drainage and relieve pressure.
4. A healthcare provider performs nasal/sinus endoscopy with orbital decompression of the medial and inferior walls to address proptosis in a patient with thyroid eye disease.
5. A patient with a history of trauma undergoes nasal/sinus endoscopy with orbital decompression of the medial and inferior walls to correct orbital deformities and improve visual function.