Summary & Overview
Billing Code 31237: Nasal Endoscopy with Biopsy, Polypectomy, or Debridement
Billing Code code 31237 represents a nasal endoscopic procedure in which a provider examines the nasal cavity with an endoscope and performs a concurrent minor surgical intervention such as nasal biopsy, polypectomy, or debridement. This procedure is commonly used to evaluate and treat intranasal pathology—such as nasal polyps, chronic sinonasal inflammation, and localized lesions—while allowing tissue sampling or removal in the same encounter. Nationally, 31237 matters because it sits at the intersection of diagnostic endoscopy and minor surgical care in otolaryngology, affecting site-of-service decisions, coding specificity, and payment pathways across commercial and public payers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise overview of clinical context and typical indications for use, payer coverage considerations, and how this code relates to other endoscopic nasal/sinus surgical codes. The publication outlines common use cases (biopsy, polypectomy, debridement), expected sites of service (office or ambulatory surgical center), and connections to related procedural codes for more extensive sinus surgery. The content is intended for billing professionals, clinical coders, and policy analysts seeking clear operational and clinical framing of 31237 in a national context.
Billing Code Overview
Billing Code code 31237 describes a diagnostic nasal endoscopy with concurrent targeted procedure: the provider inserts an endoscope into the nasal cavity to inspect nasal contents and then performs a nasal biopsy, polypectomy, or debridement.
Service Type: Nasal endoscopic diagnostic procedure with minor surgical intervention
Typical Site of Service: Ambulatory surgical center or office-based otolaryngology clinic, depending on clinical setting and complexity.
Clinical & Coding Specifications
Clinical Context
A patient presents to an otolaryngology (ENT) clinic with symptoms such as nasal congestion, facial pain, or recurrent sinus infections. The provider suspects conditions like nasal polyps, chronic or acute sinusitis, or structural abnormalities such as a deviated septum. After clinical evaluation, the provider determines that a surgical nasal/sinus endoscopy is necessary. During the procedure, the provider uses an endoscope to visualize the nasal cavity and sinuses, and performs a biopsy, polypectomy, or debridement as indicated. This is typically performed in an office or outpatient facility setting. The procedure is documented under CPT code 31237 for surgical endoscopy with biopsy, polypectomy, or debridement.
Coding Specifications
Common Modifiers:
| Modifier Code | Description | When Used |
|---|---|---|
50 | Bilateral procedure | When the procedure is performed on both sides of the nose/sinuses. |
79 | Unrelated procedure or service by the same physician during the postoperative period |