Otolaryngology Coding Alert

Question: May we report a sinusotomy separately when the ENT performs this procedure to remove tissue and gain access for a frontal sinus endoscopy (31276)?


Illinois Subscriber
Answer: Unlike other nasal endoscopies, tissue removal is included in frontal sinus endoscopy (31276, Nasal/sinus endoscopy, surgical with frontal sinus exploration, with or without removal of tissue from frontal sinus). Specifically, 31276's intraservice work includes removal of obstructing frontal recess cells, polyps or scar tissue.

If necessary, the surgeon may remove intersinus septi from the dome of the ethmoid and skull base. The physician may also remove ostetic bone between the frontal sinus and a supraorbital ethmoid cell.

On occasion, the ENT may have difficulty accessing the tissue via the endoscope and may therefore perform a sinusotomy, 31070 (Sinusotomy, frontal; external, simple [trephine operation]). The National Correct Coding Initiative (NCCI) bundles 31070 to 31276. Therefore, you should not report 31070 separately with 31276.

Exception: The edit bundling 31070 to 31276 includes a -1- modifier indicator, meaning that you may break the edit by applying modifier 59 (Distinct procedural service) if the nasal endoscopy (31276) and the sinusotomy (31070) occur in different areas (such as contralateral sides).