Summary & Overview
CPT 31299: Unlisted Accessory Sinus Procedure
CPT code 31299 is an unlisted procedure code for accessory sinus procedures that lack a specific CPT descriptor. It matters nationally as a catch-all billing mechanism for surgeons and facilities performing atypical or novel operative work in the accessory sinuses, and it is commonly used when documentation and medical necessity must justify reimbursement. The code affects physician and facility claims across major commercial payers and Medicare.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for accessory sinus procedures, typical sites of service, and payer coverage considerations. The publication outlines benchmarking approaches and common billing practices tied to unlisted procedure reporting, highlights documentation and coding elements that influence claim adjudication, and summarizes payer-specific trends where available. It also flags where input data are not provided and identifies areas—such as associated taxonomies and ICD-10 pairings—where additional payer guidance may be required.
This summary provides a national perspective on usage and administrative handling of 31299, offering a foundation for coding, billing, and policy review without state-specific nuance.
Billing Code Overview
CPT code 31299 is an unlisted procedure code used to report surgical or procedural work in the accessory sinuses when no specific CPT code applies. This code captures procedures performed on accessory sinus structures that are not otherwise described by a listed CPT code.
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Service type: Surgical procedure on accessory sinuses
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Typical site of service: Operating room or ambulatory surgical center for sinus surgery procedures
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an otolaryngology clinic with persistent symptoms of sinus disease localized to accessory sinuses (eg, frontal recess variants, anterior or posterior ethmoid air cells, supraorbital or suprabullar cells) that are refractory to medical therapy. The clinician documents chronic or recurrent sinus drainage, facial pressure and failure of prolonged antibiotics, nasal corticosteroid therapy, and saline irrigations. Preoperative evaluation includes nasal endoscopy, sinonasal CT imaging to define anatomy and disease extent, medical history review, and anesthesia assessment.
During the procedure performed under monitored anesthesia care or general anesthesia in an ambulatory surgery center or hospital operating room, the surgeon uses endoscopic instruments to access and address disease in accessory sinuses where no specific CPT exists. Actions may include limited removal of obstructing mucosal disease, drainage of isolated accessory cells, removal of obstructive bony partitions, or targeted marsupialization. The procedure is reported with 31299 when the work performed is not described by a specific sinus CPT. Typical intraoperative documentation includes the anatomic sites treated, extent of tissue removal, hemostasis achieved, and any complications. Postoperative care includes recovery monitoring, short course of analgesics and antibiotics as indicated, nasal saline irrigations, and outpatient follow-up for debridement and endoscopic surveillance.
Coding Specifications
| Modifier | Description | When to Use |
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