How To Use CPT Code 31296

CPT 31296 describes the surgical procedure of nasal/sinus endoscopy with dilation of the frontal sinus ostium using a balloon dilation technique. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 31296?

CPT 31296 is a code used to describe a surgical procedure called nasal/sinus endoscopy with dilation of the frontal sinus ostium. This procedure involves the use of an endoscope to access the nasal cavity and dilate the opening of the frontal sinus. The dilation is achieved using a balloon dilation technique.

2. Official Description

The official description of CPT code 31296 is: ‘Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal sinus ostium.’ This code should not be reported in conjunction with other specific codes when performed on the same side.

3. Procedure

1. The provider begins by preparing and anesthetizing the patient appropriately for the procedure.
2. A topical nasal decongestant is applied to the patient’s nasal cavity before the dilation procedure.
3. The provider inserts a flexible wire through the nose into the orifice that connects the frontal sinus with the nasal cavity.
4. A balloon catheter is then threaded over the guidewire and positioned in the frontal ostium.
5. The provider confirms the position of the balloon and the flexible wire using an endoscope.
6. The balloon is inflated to dilate the frontal sinus ostium.
7. At the end of the procedure, the balloon is deflated and removed.

4. Qualifying circumstances

CPT 31296 is performed on patients who require dilation of the frontal sinus ostium. This procedure is typically indicated for patients with conditions such as chronic sinusitis or nasal polyps that cause narrowing or blockage of the frontal sinus opening. It is important to note that CPT 31296 should not be reported in conjunction with specific codes when performed on the same side.

5. When to use CPT code 31296

CPT code 31296 should be used when a provider performs nasal/sinus endoscopy with dilation of the frontal sinus ostium using a balloon dilation technique. 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 31296, the provider must document the following information:

• Patient’s diagnosis and the need for frontal sinus ostium dilation
• Details of the procedure, including the use of a balloon dilation technique
• Date of the procedure
• Any additional relevant information or findings during the procedure
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 31296, ensure that the procedure involves the dilation of the frontal sinus ostium using a balloon dilation technique. It is important to note that this code should not be reported in conjunction with specific codes when performed on the same side. Modifier 50 should be used for bilateral procedures, and modifiers LT and RT should be appended for procedures performed on the left and right sides, respectively, based on payer preference.

8. Historical information

CPT 31296 was added to the Current Procedural Terminology system on January 1, 2011. On January 1, 2020, the code description was updated to specify the dilation of the frontal sinus ostium using a balloon dilation technique.

9. Examples

1. A provider performs nasal/sinus endoscopy with dilation of the frontal sinus ostium using a balloon dilation technique to treat a patient with chronic sinusitis.
2. During a surgical procedure, a provider uses CPT 31296 to dilate the frontal sinus ostium of a patient with nasal polyps.
3. A patient undergoes nasal/sinus endoscopy with dilation of the frontal sinus ostium using a balloon dilation technique to alleviate symptoms of recurrent sinus infections.
4. A provider performs CPT 31296 to dilate the frontal sinus ostium of a patient with a history of chronic sinusitis and nasal congestion.
5. During a surgical procedure, a provider uses CPT 31296 to dilate the frontal sinus ostium of a patient with a deviated septum.
6. A patient undergoes nasal/sinus endoscopy with dilation of the frontal sinus ostium using a balloon dilation technique to improve sinus drainage and alleviate facial pain.
7. A provider performs CPT 31296 to dilate the frontal sinus ostium of a patient with recurrent sinus infections and nasal polyps.
8. During a surgical procedure, a provider uses CPT 31296 to dilate the frontal sinus ostium of a patient with chronic sinusitis and nasal congestion.
9. A patient undergoes nasal/sinus endoscopy with dilation of the frontal sinus ostium using a balloon dilation technique to address chronic sinusitis and improve sinus drainage.
10. A provider performs CPT 31296 to dilate the frontal sinus ostium of a patient with nasal polyps and recurrent sinus infections.