CPT 31240: Endoscopic Intranasal Procedure for Concha Bullosa Removal
CPT code 31240 represents an endoscopic intranasal procedure used to assist with removal or reduction of a concha bullosa — an air pocket within a nasal turbinate. This code is significant nationally because it identifies a common surgical approach within otolaryngology for patients with symptomatic turbinate pathology that can impact breathing, sinus function, and quality of life. Use of this code affects facility and professional billing in ambulatory surgical centers and hospital outpatient departments.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and which payers commonly process claims for this service. The publication outlines standard benchmarking elements and policy-relevant issues tied to coverage and coding for endoscopic nasal procedures, and explains how CPT code 31240 fits into broader otolaryngology service lines.
The report provides practical reference material: a clear description of the procedure, expected billing context, common modifiers and claim components (listed elsewhere in the publication), and notes on where to find related codes and clinical documentation points. Data not provided in the input is identified as such.
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Billing Code Overview
CPT code 31240 describes an endoscopic intranasal procedure performed to assist with concha bullosa removal. In this procedure, a provider inserts an endoscope into the nasal cavity to visualize the middle turbinate and facilitate reduction or excision of an air-filled cavity (concha bullosa) within a turbinate bone.
Service type: Endoscopic nasal surgery / nasal turbinate procedure
Typical site of service: Ambulatory surgical center or hospital outpatient department, depending on clinical complexity and facility resources.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 25–50-year-old adult presenting to an otolaryngology clinic with chronic nasal obstruction, facial pressure, or recurrent sinusitis refractory to medical therapy. Examination with nasal endoscopy and CT imaging demonstrates a concha bullosa ( pneumatized middle turbinate ) causing significant lateralization or contact with the nasal septum and obstructing the middle meatus. After failed conservative measures (intranasal steroids, nasal saline, antibiotics as indicated), the patient is scheduled for an endoscopic partial or total middle turbinate resection or lateralization under CPT 31240 — nasal endoscopy, surgical, with concha bullosa resection. The procedure is typically performed in an ambulatory surgery center or hospital operating room under general anesthesia with monitored anesthesia care. The clinical workflow includes preoperative evaluation and informed consent, topical and local decongestion in the nose, endoscopic visualization, removal or reduction of the pneumatized turbinate with forceps, microdebrider, or powered instrumentation, intraoperative hemostasis, and postoperative instructions with topical irrigations and follow-up for endoscopic exam and possible debridement. Perioperative documentation should include indication, CT or endoscopy findings, laterality, extent of resection (partial vs total), hemostasis method, and any intraoperative complications. Common intraoperative adjuncts may include septoplasty or endoscopic sinus surgery if concurrent pathology is present; those additional procedures are reported with their appropriate CPT codes when performed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the surgeon’s professional service separated from technical facility charges, if payer requires split billing. |
50 | Bilateral procedure | Use when identical bilateral concha bullosa resections are performed and the payer requires a bilateral modifier. |
51 | Multiple procedures | Use when CPT 31240 is one of multiple distinct procedures performed in the same operative session and payer requires listing of multiple procedures. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as originally planned. |
53 | Discontinued procedure | Use when the procedure is started but discontinued due to extenuating circumstances. |
59 | Distinct procedural service | Use to indicate a separate, distinct service from another procedure performed on the same date when not normally reported together. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons performing distinct portions of the procedure. |
78 | Unplanned return to OR | Use when there is an unplanned return to the operating room for a related procedure during the global period. |
79 | Unrelated procedure or service | Use when an additional procedure during the postoperative period is unrelated to the original procedure. |
AS | Ambulatory surgery center (ASC) facility | Use to identify the service was performed in an ASC for payers that require facility place-of-service modifiers. |
LT | Left side | Use to designate procedures performed on the left nasal cavity when laterality is required. |
RT | Right side | Use to designate procedures performed on the right nasal cavity when laterality is required. |
52 | Reduced services | Use when the service is partially reduced or not completed as planned (listed again here because it is commonly applicable). |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207V00000X | Otolaryngology (ENT) | Primary specialty performing endoscopic nasal procedures including concha bullosa resection. |
| 2080P0006X | Otolaryngology - Pediatric | Performs similar procedures in pediatric populations when indicated. |
| 208D00000X | General Surgery (Head & Neck) | Head and neck surgeons who practice endoscopic sinonasal surgery may perform this procedure. |
| 363A00000X | Anesthesiology | Provides anesthesia care for CPT 31240 in operative settings. |
| 193200000X | Rhinology (subspecialty) | Specialists focused on sinus and nasal surgery commonly perform endoscopic turbinate procedures. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
J34.89 | Other specified disorders of nose and nasal passages | Commonly used for symptomatic concha bullosa when a more specific code is not documented. |
J34.2 | Deviated nasal septum | Frequently coexists with concha bullosa and contributes to nasal obstruction; often addressed concurrently. |
J32.9 | Chronic sinusitis, unspecified | Chronic rhinosinusitis may coexist and require concurrent endoscopic sinus procedures. |
J33.9 | Nasal polyp, unspecified | Polyps in the middle meatus or ethmoid complex can be present with concha bullosa and may be removed in the same setting. |
R09.81 | Nasal congestion | Symptom code reflecting patient complaints leading to evaluation and possible concha bullosa resection. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
31237 | Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure) | May be performed during the same session for mucosal disease or polyp removal in the middle meatus alongside concha bullosa resection. |
31267 | Nasal/sinus endoscopy, surgical, with dilation of the frontal sinus ostium or sphenoidotomy (endoscopic) | Performed when concurrent sinus ostial procedures are indicated during comprehensive endoscopic sinus surgery. |
30420 | Submucous resection inferior turbinate, partial or complete, any method | Performed when inferior turbinate hypertrophy contributes to obstruction in addition to concha bullosa; reported separately if done. |
30520 | Septoplasty or submucous resection, primary | Often performed concurrently when a deviated nasal septum contributes to obstruction; report separately. |
31254 | Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial | Performed when ethmoid disease requires surgical management during the same operative session. |
99152 | Anesthesia for procedures on nose/sinuses, for more complex cases (example code for context) | Anesthesia codes are reported by anesthesia providers to indicate intraoperative anesthesia services when applicable. |