Summary & Overview
CPT 31241: Endoscopic Sphenopalatine Artery Ligation for Epistaxis
CPT code 31241 represents an endoscopic nasal surgical procedure in which the sphenopalatine artery (SPA) is ligated or occluded via endoscopic access through a nostril to control epistaxis or hemorrhage during tumor removal. Nationally, this code is important for otolaryngology surgical billing because it captures definitive, procedural management of posterior nasal bleeding and intraoperative bleeding control during sinonasal tumor resections. Proper coding affects facility and professional payment alignment for endoscopic sinus and skull base services.
Key payers commonly included in coverage discussions are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The analysis typically addresses facility and surgeon billing, site-of-service implications, and documentation elements that support medical necessity for arterial ligation procedures.
Readers will learn clinical context for when CPT code 31241 is used, typical sites of service, payer coverage considerations, and common documentation points tied to procedural indication (epistaxis control or hemorrhage management during tumor removal). Data elements such as payer-specific coverage policies, reimbursement benchmarks, and coding guidance are addressed where available. Data not available in the input will be identified as such in relevant sections.
Billing Code Overview
CPT code 31241 describes an endoscopic nasal procedure in which a provider inserts an endoscope through a nostril to examine the nasal cavity and sinuses and ties off the sphenopalatine artery (SPA) to control epistaxis or to control bleeding during tumor removal. This is an endoscopic sphenopalatine artery ligation or occlusion procedure.
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Service type: Endoscopic nasal surgical procedure for arterial ligation to control bleeding
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Typical site of service: Hospital operating room or ambulatory surgical center, with endoscopic access via the nasal cavity
Clinical & Coding Specifications
Clinical Context
A 46-year-old patient presents to the otolaryngology clinic with recurrent, severe posterior epistaxis refractory to anterior packing and topical vasoconstrictors. After failed conservative measures and persistent bleeding, the patient is taken to the operating room for endoscopic evaluation. Under general anesthesia, the surgeon introduces a nasal endoscope through a nostril to inspect the nasal cavity and posterior choanae, identifies active bleeding from branches of the sphenopalatine artery, and performs endoscopic ligation/occlusion of the sphenopalatine artery (CPT 31241). Hemostasis is confirmed endoscopically. Typical workflow includes preoperative assessment and imaging as needed, intraoperative endoscopic visualization and SPA ligation, hemostasis verification, and postoperative monitoring in the PACU with instructions for nasal care and follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Provider does not use a modifier | Rarely used; include only per payer policy when no modifier applies |
11 | Normal, everyday physician service |