Summary & Overview
CPT 31298: Endoscopic Balloon Dilation of Frontal and Sphenoid Sinus Ostia
CPT code 31298 denotes endoscopic balloon dilation of the ostia of the frontal and sphenoid sinuses using a balloon-tipped catheter passed through the nasal cavity. This minimally invasive sinus procedure is used to enlarge sinus openings and restore ventilation and drainage, reducing symptoms associated with chronic rhinosinusitis and other obstructive sinus conditions. Nationally, the code is relevant to ambulatory surgical and hospital outpatient settings where otolaryngology practices and ear, nose, and throat specialists perform image-guided or endoscopic procedures.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines payer coverage patterns, coding and billing benchmarks, clinical context for appropriate use, and relevant policy or reimbursement updates affecting outpatient endoscopic sinus interventions. Readers will find a concise clinical description, typical site-of-service guidance, common billing modifiers and codes when available, and comparative benchmarks where data exists. When specific input fields were not provided, the text notes that data is not available in the input. The intent is to give coding, billing, and policy stakeholders a clear, national-level reference for CPT code 31298 and its role in modern sinus care delivery.
Billing Code Overview
CPT code 31298 describes dilation of the ostium of the frontal and sphenoid sinuses using a balloon-tipped catheter passed through an endoscope introduced via the nasal cavity. This procedure is an endoscopic sinus intervention performed to enlarge sinus ostia and improve sinus drainage.
Service Type: Endoscopic balloon dilation of frontal and sphenoid sinus ostia
Typical Site of Service: Ambulatory surgical center or hospital outpatient department (endoscopic nasal/sinus procedure)
Clinical & Coding Specifications
Clinical Context
A typical patient is a 35–60-year-old adult presenting to an otolaryngology clinic with chronic frontal and/or sphenoid sinusitis characterized by persistent nasal congestion, frontal or retro-orbital pressure, purulent drainage, and failure of maximal medical therapy (intranasal corticosteroids, oral antibiotics, and saline irrigations). After nasal endoscopy and sinus CT confirming ostial narrowing or obstruction of the frontal and/or sphenoid sinuses, the patient is scheduled for a transnasal endoscopic balloon dilation procedure under monitored anesthesia care or general anesthesia. In the operating room or ambulatory surgery center, the surgeon introduces a nasal endoscope and advances a balloon-tipped catheter through the natural ostium into the frontal and/or sphenoid sinus ostia. The balloon is inflated to dilate the ostium, restoring ventilation and drainage while preserving mucosa. Hemostasis is achieved, intraoperative findings are documented (sinus anatomy, extent of disease, size and location of ostial stenosis), and post-procedure instructions and topical therapies are provided. Typical sites of service include the ambulatory surgery center (ASC) or hospital outpatient department (HOPD).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | (No special meaning; placeholder) | Reserved; not typically appended to claim lines — use payer-specific guidance. |