Summary & Overview
HCPCS G9349: CT Scan of Paranasal Sinuses, Diagnostic Imaging
HCPCS Level II code G9349 designates a computed tomography (CT) scan of the paranasal sinuses performed at the time of diagnosis or within 28 days thereafter. This imaging code captures early diagnostic CT use for patients with suspected sinus disease, facial trauma, or other sinonasal pathology where cross-sectional imaging is needed to inform initial management. Nationally, timely imaging during the diagnostic window can affect care pathways, referrals to specialists, and subsequent resource use.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for G9349, standard sites of service, and the typical service type. The publication summarizes payer coverage patterns and reimbursement benchmarks where available, highlights relevant policy considerations affecting early diagnostic imaging, and places the code in clinical context for providers, billing teams, and policy analysts.
This summary is intended to help stakeholders understand what HCPCS Level II code G9349 represents, how it is used in initial diagnostic workflows for sinonasal conditions, and which major payers are typically involved in coverage decisions. Data not provided in the input are noted where applicable.
Billing Code Overview
HCPCS Level II code G9349 describes a CT scan of the paranasal sinuses that is either ordered at the time of diagnosis or performed within 28 days after the date of diagnosis. This service represents advanced imaging used to evaluate sinus anatomy and pathology at or shortly after initial diagnostic evaluation.
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Service type: Diagnostic imaging, computed tomography (CT) of the paranasal sinuses
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Typical site of service: Outpatient radiology departments, hospital outpatient departments, and ambulatory imaging centers
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 34-year-old adult presents to an otolaryngology clinic with 3 weeks of facial pressure, purulent nasal drainage, and worsening nasal congestion following an upper respiratory infection. On clinical exam the provider documents tenderness over the maxillary sinuses and persistent symptoms despite 10 days of appropriate antibiotics. A CT scan of the paranasal sinuses is ordered at the time of diagnosis to evaluate for acute complicated sinusitis, assess extent of mucosal disease, and to identify anatomic variants that may affect management. Imaging is performed in an outpatient radiology suite within 28 days of the diagnosis date. The CT acquisition includes thin axial and coronal reformats of the paranasal sinuses, and the radiologist provides an interpretive report to the ordering otolaryngologist. Results may direct medical management or operative planning, such as endoscopic sinus surgery if obstructive disease, deviant septum, or mucocele is identified.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the CT required substantially greater resources or time due to complexity (for example extensive scanning or prolonged interpretation). |
23 | Unusual anesthesia |