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CPT 31295: Endoscopic Maxillary Sinus Ostial Dilation
CPT code 31295 denotes endoscopic dilation of the maxillary sinus ostium, a minimally invasive sinonasal procedure used to restore drainage and ventilation of the maxillary sinus. This procedure is clinically important for management of chronic rhinosinusitis and recurrent maxillary sinus obstruction, and it has implications for access, utilization, and coding consistency across national payers. Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find concise benchmarks and clinical context for CPT code 31295, including typical sites of service, common billing considerations, and where this code fits within the spectrum of endoscopic sinus interventions. The publication outlines payer coverage patterns and coding considerations relevant to outpatient and ambulatory surgery settings, highlights policy updates that affect coding and claims adjudication, and summarizes practical issues that impact utilization and documentation. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 31295 describes endoscopic dilation of the maxillary sinus ostium. The procedure involves passing an endoscope into the nasal cavity and dilating the opening (ostium) of the maxillary sinus, either via a purely transnasal approach or through the canine fossa (a depression on the outer surface of the maxilla).
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Service type: Endoscopic sinus procedure (maxillary sinus ostial dilation)
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Typical site of service: Ambulatory surgery center or hospital outpatient department; may also be performed in specialized office settings equipped for endoscopic sinus procedures.