Clinical Indicators
Ethmoidectomy

Procedure CPT FUD
Ethmoidectomy, intranasal, anterior 31200 90
Ethmoidectomy, intranasal, total 31201 90
Ethmoidectomy, extranasal, total 31205 90
Sinusotomy combined (3 or more) 31090 90
Nasal/sinus endoscopy, with partial ethmoidecomy 31254 0
Nasal endoscopy, with total ethmoidectomy 31255 0
Nasal/sinus endoscopy, surgical; with repair of cerebrospinal fluid leak; ethmoid region 31290 10
Nasal/sinus endoscopy, surgical; with medial or inferior orbital wall decompression 31292 10
Nasal/sinus endoscopy, surgical; with medial and inferior orbital wall decompression 31293 10
Nasal/sinus endoscopy, surgical; with
optic nerve decompression
31294 10

Indications

1. History... one or more required

a) Failure of medical management (describe) for acute or chronic ethmoid sinusitis. 
b) Orbital or cranial extension of ethmoiditis. 
c) Ethmoid enlargement (polyp or tumor) causing nasal obstruction. 
d) Multiple or recurrent nasal polyps causing obstruction. 
e) Impaired sense of smell. 

2. Physical Examination

a) Description of complete anterior and posterior (if possible) nasal exam required. 

3. Tests

a) Sinus imaging--describe...required. 
b) Culture and sensitivity--optional, describe results. 
c) Endoscopy. 

Postoperative Observations

1. Bleeding, eyelid ecchymosis--how managed? Surgeon notified?
2. Pain--severe headache; notify physician.
3. Packing--is it in desired location?
4. Vision--if there is loss or double vision, notify surgeon immediately.
5. Swelling--is there evidence of facial edema? If hematoma, how managed? Surgeon notified?
6. Mental status-is patient alert and oriented?

Outcome Review

1. One Week

a) Healing--Did patient require treatment for bleeding or infection? Is site healing satisfactorily? 
b) Pathology--Does the pathology report indicate need for further treatment and if so, how managed? 
c) Are there any indicators for CSF rhinorrhea? 
2.Beyond One Month
a) Presenting problem--Is it (see history) improved? 
b) Airway--Is there evidence of airway obstruction due to polyps or nasal crusting? 
c) Are there any indicators for CSF rhinorrhea? 

Associated ICD-9 Diagnostic Codes

212.0 Benign neoplasm of nasal cavities, middle ear, and accessory sinuses
461.2 Acute ethmoid sinusitis
471.8 Other polyp of sinus
473.2 Chronic ethmoidal sinusitis
160.3 Ethmoid sinus neoplasm, malignant, primary
197.3 Ethmoid sinus neoplasm, malignant, secondary
231.8 Ethmoid sinus neoplasm, Ca in situ
235.9 Ethmoid sinus neoplasm, uncertain behavior
239.1 Ethmoid sinus neoplasm, unspecified
170.0 Ethmoid bone or labyrinth neoplasm, malignant, primary
198.5 Ethmoid bone or labyrinth neoplasm, malignant, secondary
213.0 Ethmoid bone or labyrinth neoplasm, benign
238.0 Ethmoid bone or labyrinth neoplasm, uncertain behavior
239.2 Ethmoid bone or labyrinth neoplasm, unspecified
478.1 Nasal airway obstruction

Additional Information
Assistant Surgeon -- N
Supply Charges -- N
Prior Approval -- N

Anesthesia Code(s)
00160

Patient Information
Ethmoidectomy is performed through either an external (facial), transantral (maxillary sinus), or intranasal (endoscopic) approach. The decision regarding the best approach to the ethmoid sinus depends on certain technical considerations best decided by the surgeon. This surgery is per- formed only after it has been determined that medical management has been unsuccessful. Surgery, medical management, and failure to treat ethmoid disease all have similar risks. They include orbital complications (visual impairment), intra-cranial extension (brain damage or infection), persistent or recurrent nasal obstruction due to failure to manage polyps, and recurrent nasal infections.

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.