Summary & Overview
HCPCS G9351: Repeat CT of Paranasal Sinuses Within 90 Days
HCPCS Level II code G9351 designates repeat computed tomography (CT) imaging of the paranasal sinuses performed more than once within 90 days after an initial diagnosis. This code captures instances of additional or follow-up sinus CTs—often ordered for evolving symptoms, complication assessment, or preprocedural planning—and has implications for utilization tracking, prior authorization workflows, and payment policies at a national level. Key payers in the coverage landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise explanation of what G9351 represents, the clinical scenarios that typically prompt repeat sinus CT imaging, and the common sites of service where these scans occur. The publication summarizes benchmark concepts and policy-relevant issues such as utilization monitoring, potential documentation requirements, and interactions with prior authorization and coverage rules. It also outlines where data was unavailable in the source input and where readers should expect to consult payer-specific policies for coverage criteria and billing guidance.
Billing Code Overview
HCPCS Level II code G9351 describes instances where more than one CT scan of the paranasal sinuses is ordered or received within 90 days after diagnosis. The code applies to repeat or additional computed tomography imaging focused on the paranasal sinus cavities following an initial diagnostic encounter.
Service Type: Diagnostic imaging — computed tomography (CT) of the paranasal sinuses
Typical Site of Service: Outpatient imaging centers, hospital outpatient departments, and emergency departments
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 42-year-old patient presents to an otolaryngology clinic with acute facial pain, purulent nasal discharge, and worsening nasal obstruction for 10 days after an initial diagnosis of acute rhinosinusitis. A non-contrast CT scan of the paranasal sinuses is performed at the outpatient radiology suite to evaluate extent of disease. Symptoms persist and there is concern for complications or surgical planning; a second CT scan of the paranasal sinuses is ordered and performed 60 days after the initial scan to assess progression and to guide functional endoscopic sinus surgery planning.
The clinical workflow includes physician evaluation and documentation of changing symptoms or new clinical findings, ordering the repeat CT of the paranasal sinuses with appropriate clinical justification, scheduling at an outpatient imaging center or hospital radiology department, performance of the scan with CT sinuses protocol, radiologist interpretation, and incorporation of imaging into the surgical consent and operative planning if indicated.
Typical site of service: Outpatient imaging center, hospital outpatient radiology department, or ambulatory surgery center when performed for preoperative planning. Service type: Diagnostic imaging — repeat CT of the paranasal sinuses within 90 days after diagnosis.
Coding Specifications
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