There have been a number of member inquiries on the correct usage of CPT® codes 31233 Nasal/sinus endoscopy, diagnostic with maxillary sinusoscopy (via inferior meatus or canine fossa puncture) and 31235 Nasal/sinus endoscopy, diagnostic with sphenoid sinusoscopy (via puncture of sphenoidal face or cannulation of ostium). Some who perform endoscopic exams after the postoperative global period to view the interior of maxillary or sphenoid sinuses through existing surgically created patent sinusotomies are reporting 31233 or 31235 (or, perhaps both).
When the physician performs endoscopic exams postoperatively (to view the interior of maxillary or sphenoid sinuses through existing surgically created patent sinusotomies), the Academy’s position is that only CPT code 31231 Nasal/sinus endoscopy, diagnostic, unilateral or bilateral (separate procedure) is appropriate. Our rationale is that CPT codes 31233 and 31235 require a puncture or trocar cannulation prior to placing the scope into the sinus. CPT code 31231 is bilateral while the CPT codes 31233 and 31235 are unilateral. The use of CPT code 31233 or 31235 to report diagnostic sinus endoscopy performed via an existing and patent opening into the maxillary or sphenoid sinus is incorrect.
Reviewed October 2023