| Clinical Indicators
Diagnostic Nasal Endoscopy
| Procedure |
CPT |
FUD |
| Nasal endoscopy, diagnostic, unilateral or
bilateral.* |
31231 |
0 |
*Note: Separate Procedure
This guideline does not apply to surgical procedures. |
|
|
Indications
1. History...one or more required
| a) |
Obstructed nasal breathing. |
| b) |
Epistaxis, anterior or posterior, either active or past history
of. |
| c) |
Facial pain or headache consistent with sinonasal origin. |
| d) |
Purulent nasal drainage (anterior or posterior) of more than
two weeks. |
| e) |
Sinus barotrauma (after flying or diving). |
| f) |
Watery rhinorrhea suggestive of cerebrospinal fluid leak. |
| g) |
Persistent sinus abnormality on radiographs. |
| h) |
Findings suggestive of nasal foreign body. |
| i) |
Intranasal soft tissue mass. |
| j) |
Bloody drainage noted on nasopharyngeal
examination. |
| k) |
Follow-up examination of known nasal, sinus, or
nasopharyngeal neoplasm. |
| l) |
Anosmia or hyposmia |
| m) |
Follow-up examination following sinus surgery |
2. Physical Examination...one required
| a) |
Anterior rhinoscopy insufficient to account for symptoms. |
| b) |
Abnormal anterior rhinoscopy requiring more thorough nasal
evaluation. |
Post-Procedure Observations
| 1. |
Nasal bleeding. |
| 2. |
New nasal or facial pain. |
Outcome Review
| 1. |
Document any complications on same day of procedure for peer
review purposes. |
Associated ICD-9 Diagnostic Codes
| 160.0 |
Carcinoma nasal cavity |
| 160.1 |
Carcinoma auditory tube, middle ear, mastoid |
| 160.2 |
Carcinoma maxillary sinus |
| 160.3 |
Carcinoma ethmoid sinus |
| 160.4 |
Carcinoma frontal sinus |
| 160.5 |
Carcinoma sphenoid sinus |
| 160.8 |
Carcinoma sinuses, other sites, overlapping |
| 160.9 |
Carcinoma sinuses, NOS 172 Malignant melanoma |
| 212.0 |
Benign neoplasm of nasal cavity and accessory
sinuses |
| 231.8 |
Carcinoma in-situ, nasal, sinus |
| 349.81 |
Rhinorrhea, cerebrospinal (fluid) |
| 352.0 |
Disorders of olfaction |
| 461.9 |
Acute sinusitis |
| 388.44 |
Recruitment |
| 388.5 |
Disorders of acoustic nerve |
| 389.10 |
Sensorineural hearing loss, unspecified |
| 389.11 |
Sensory hearing loss |
| 389.12 |
Neural hearing loss |
| 389.14 |
Central hearing loss |
| 389.18 |
Sensorineural hearing loss of combined types |
| 389.2 |
Mixed conductive and sensorineural hearing
loss |
| 389.7 |
Deaf mutism, not elsewhere classified |
| 470 |
Deviated nasal septum, acquired |
| 471.0 |
Nasal polyposis |
| 471.1 |
Polypoid degeneration |
| 471.8 |
Polyp of sinus |
| 472.2 |
Chronic rhinitis |
| 473.0 |
Chronic maxillary sinusitis |
| 473.1 |
Chronic frontal sinusitis |
| 473.2 |
Chronic ethmoidal sinusitis |
| 473.3 |
Chronic sphenoidal sinusitis |
| 473.8 |
Chronic pansinusitis |
| 473.9 |
Sinusitis, chronic (may also code for specific
sinus) |
| 477.0 |
Allergic rhinitis due to pollen |
| 477.8 |
Allergic rhinitis due to other allergen |
| 477.9 |
Vasomotor rhinitis |
| 477.9 |
Allergic/vasomotor rhinitis |
| 478.0 |
Hypertrophy of nasal turbinates |
| 478.1 |
Other diseases of nasal cavity (including
obstruction and rhinorrhea) |
| 738.0 |
Nasal deformity, acquired |
| 748.0 |
Choanal atresia |
| 748.1 |
Cleft nose |
| 754 |
Deviated nasal septum, congenital |
| 781.01 |
Disturbances of sensation of smell |
| 784.0 |
Headache |
| 784.7 |
Epistaxis |
| 802.0 |
Fracture, nasal (bones), closed |
| 802.1 |
Fracture, nasal (bones), open |
| 932 |
Foreign body in nose |
| 993.1 |
Barotrauma, sinus |
Additional Information
Supply charges—N
Prior approval—N
Assistant Surgeon—N
Additional Information
Anesthesia Code(s) 00160
Patient Information
Nasal endoscopy is done when there may be a condition or disease in the nose or
sinuses that is not adequately visualized on routine examination. The nose may
be sprayed with a decongestant and anesthetic before insertion of a rigid
and/or flexible endoscope. The procedure can be performed on both adults and
children comfortably. The throat may be numb for several minutes following use
of an anesthetic.
Important Notice
The Clinical Indicators for Otolaryngology--Head and Neck Surgery
are guidelines only. In no sense do they represent a standard of care. The
applicability of an indicator for a procedure, and/or of the process or outcome
criteria, must be determined by the responsible physician in light of all the
circumstances presented by the individual patient. Adherence to these
guidelines will not ensure successful treatment in every situation. The
American Academy of Otolaryngology-Head and Neck Surgery, Inc. emphasizes that
these clinical indicators should not be deemed inclusive of all proper
treatment decisions or methods of care, nor exclusive of other treatment
decisions or methods of care reasonably directed to obtaining the same
results.
© 2000 American Academy of Otolaryngology-Head and Neck Surgery. One
Prince Street, Alexandria, VA 22314.
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