Otolaryngology Coding Alert

Answer: First, you’ll submit 31297 (Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium [e.g., balloon dilation]) for the procedure itself. Current coding edits do not bundle 31297 with 21337 (Closed treatment of nasal septal fracture, with or without stabilization), so the payer might allow you to bill both codes if you have supporting documentation. Be sure to link the procedure codes with the appropriate diagnosis codes. 

 

Take note: CPT® code 30930 (Fracture nasal inferior turbinate[s], therapeutic) can be reported if the physician purposely fractures the turbinates. If he performs therapeutic fracture of the middle turbinates, you submit 30999 (Unlisted procedure, nose).  

 

Also understand that it’s not uncommon to have bone fractures during balloon sinuplasty. When the surgeon expands the balloon it’s not just tissue that’s expanding but also the thin bones that make up the sinuses. The bones will fracture and then heal, leaving the sinus opening wider.