How To Use CPT Code 31294

CPT 31294 describes a surgical procedure involving nasal/sinus endoscopy with optic nerve decompression. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 31294?

CPT 31294 is used to describe a surgical procedure that involves the use of nasal/sinus endoscopy to decompress the optic nerve. This procedure is performed by a healthcare provider to relieve pressure on the optic nerve and improve the patient’s condition.

2. Official Description

The official description of CPT code 31294 is: ‘Nasal/sinus endoscopy, surgical, with optic nerve decompression.’

3. Procedure

1. The healthcare provider begins by preparing and anesthetizing the patient.
2. Using a rigid or flexible endoscope, the provider performs nasal endoscopy to achieve optic nerve decompression.
3. A topical nasal decongestant may be administered to the patient as needed.
4. The provider carefully inspects the nasal cavity and paranasal sinuses for any abnormalities.
5. The anterior and posterior ethmoidal sinuses are cleared, and the ethmoid sinus may be used to access the sphenoid sinus.
6. The provider then proceeds to thin or remove the bone over the optic nerve.
7. The bony channel of the optic nerve is exposed, and any bony fragments or blood clots impinging on the optic nerve are removed to relieve pressure.

4. Qualifying circumstances

CPT 31294 is performed on patients who require optic nerve decompression. This procedure is typically indicated for individuals experiencing compression forces on the optic nerve due to bony fragments or blood clots. It is important to note that CPT 31294 should not be reported in conjunction with certain other nasal/sinus endoscopy codes when performed on the same side.

5. When to use CPT code 31294

CPT code 31294 should be used when a healthcare provider performs nasal/sinus endoscopy with optic nerve decompression. This code accurately represents the specific procedure being performed and allows for proper billing and documentation.

6. Documentation requirements

To support a claim for CPT 31294, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for optic nerve decompression
• Details of the nasal/sinus endoscopy procedure
• Date and duration of the procedure
• Specific steps taken during the procedure, including any bone thinning or removal
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 31294, ensure that the procedure is performed by a qualified healthcare provider and that it involves nasal/sinus endoscopy with optic nerve decompression. It is important to follow any specific guidelines provided by payers regarding the use of modifiers or reporting with other codes.

8. Historical information

CPT 31294 was added to the Current Procedural Terminology system on January 1, 1994. The code was later updated on January 1, 2020, with a revised description.

9. Examples

1. A healthcare provider performs nasal/sinus endoscopy with optic nerve decompression to relieve pressure on the optic nerve in a patient with a bony fragment impinging on the nerve.
2. Using a flexible endoscope, a provider performs nasal/sinus endoscopy with optic nerve decompression to remove a blood clot causing compression on the optic nerve.
3. A patient with chronic sinusitis undergoes nasal/sinus endoscopy with optic nerve decompression to alleviate pressure on the optic nerve caused by inflammation.
4. A healthcare provider performs nasal/sinus endoscopy with optic nerve decompression to relieve pressure on the optic nerve in a patient with a history of trauma to the face.
5. Using a rigid endoscope, a provider performs nasal/sinus endoscopy with optic nerve decompression to remove a bony fragment causing compression on the optic nerve.
6. A patient with a known optic nerve disorder undergoes nasal/sinus endoscopy with optic nerve decompression to improve their visual function.
7. A healthcare provider performs nasal/sinus endoscopy with optic nerve decompression to relieve pressure on the optic nerve in a patient with a tumor near the optic nerve.
8. Using a flexible endoscope, a provider performs nasal/sinus endoscopy with optic nerve decompression to remove a foreign object causing compression on the optic nerve.
9. A patient with a history of sinus infections undergoes nasal/sinus endoscopy with optic nerve decompression to alleviate pressure on the optic nerve caused by chronic inflammation.
10. A healthcare provider performs nasal/sinus endoscopy with optic nerve decompression to relieve pressure on the optic nerve in a patient with a congenital abnormality affecting the nasal cavity.