When services may be Medically Necessary when criteria are met:
CPT | |
S2342 | Nasal endoscopy for post-operative debri ... |
ICD-10 Procedure | |
095P4ZZ-095X4ZZ | Destruction of sinus, percutaneous endos ... |
099P40Z-099X4ZZ | Drainage of sinus, percutaneous endoscop ... |
Oct 01, 2021 · 2022 ICD-10-CM Diagnosis Code Z98.89 Other specified postprocedural states 2016 2017 - Converted to Parent Code 2018 2019 2020 …
Nov 14, 2017 · ICD CODE for Sinus Lift: Hello, I've read through most of the forms and they mostly relate back to K08.21 - Minimal atrophy of the mandible K08.22 - Moderate atrophy of the mandible K08.23 - Severe atrophy of the mandible K08.24 - Minimal atrophy of maxilla K08.25 - …
40 rows · Jul 07, 2021 · ICD-10 Procedure 095P4ZZ-095X4ZZ Destruction of sinus, percutaneous endoscopic approach ...
Jul 09, 2020 · On the left side, a total ethmoidectomy and a sphenoidotomy with removal of tissue from the sphenoid. 31255-RT, 31259-LT. 31253-RT, 31256-RT. 31255-RT, 31267-RT, 31259-LT. Q: At our facility, turbinate resection/excision is done endoscopically along with other sinus procedures. Are 30130, 30140, 30801, 30802 still appropriate codes for this ...
CPT | |
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30520 | Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft |
30620 | Septal or other intranasal dermatoplasty (does not include obtaining graft) |
ICD-10 Procedure | |
09BM0ZZ | Excision of nasal septum, open approach |
CPT | |
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30520 | Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft |
Endoscopic sinus surgery was developed to treat at-risk CRS. Although morbidity is low in ESS, there is a risk of serious intra-operative complications due to the anatomic proximity of the brain, carotid artery, dura mater optic nerve, and sinus cavities. To minimize potential intra-operative complications, medical imaging-assisted mapping aids have been developed to aid surgeons performing ESS. Various computer-assisted navigation or image-guided surgery systems (IGS) have been developed in ESS in the past 20 years based on electromagnetic or infrared detection technology. Image-guidance technology gives the surgeon the ability to navigate real-time the surgical instruments to and in the diseased sinuses, correlate their position in and around vital structures while watching the monitor. This is especially useful when a patient has polyps or needs revision surgery in which the normal anatomy may be distorted. It should be noted that not all sinus surgeries require image-guidance.
Andrews et al (2018) stated that the standard of care treatment for diffuse recurrent sinus barotrauma (RSB) is an endoscopic sphenoethmoidectomy with a complete frontal dissection. Successful healing leaves the RSB patient with no ethmoid sinuses and endoscopically patent frontal, sphenoid, and maxillary ostia. In persistent cases, patients with small frontal ostia will go on to require a frontal drill-out. Patients presenting for surgical management of RSB generally have minimal sinus disease despite significant symptoms during flight and the prospect of extensive surgical management can be unappealing. With the advent of balloon sinuplasty, military otolaryngologists anticipated this technology would permit therapeutic dilation of sinus ostia without the extensive surgical dissection and prolonged recovery typical for standard of care management. This case report was a cautionary note to the wider flight community to recognize a mechanism for recurrence of the underlying pathology when balloon sinuplasty was used that was not possible after properly performed standard of care sinus surgery for RSB.
Acute rhino-sinusitis (ARS) lasts up to 12 weeks and resolves completely. Chronic rhino-sinusitis (CRS) persists over 12 weeks and may involve acute exacerbations. Rhino-sinusitis is common, affecting approximately 15 % of the population and results in significant reduction in quality of life (QOL). The diagnosis is based largely on symptoms with confirmation by nasal endoscopy. Computerized tomography (CT) scans and magnetic resonance imaging (MRI) are abnormal in about 1/3 of the population, thus, they are not recommended for routine diagnosis; but should be reserved for individuals with acute complications, diagnostic uncertainty or failed medical therapy. Underlying conditions such as immune deficiency, Wegener's granulomatosis, Churg-Strauss syndrome, aspirin hypersensitivity and allergic fungal sinusitis may present as rhino-sinusitis. Multiple therapies are used in the management of CRS with nasal polyps (CRSwNP) or without polyps (CRSsNP), including antibiotics, saline irrigations and sprays, intra-nasal and systemic glucocorticoids, and anti-leukotriene agents. Surgery should not be the first intervention in most cases, with the possible exception of allergic fungal rhino-sinusitis (Scadding et al, 2008; Hamilos, 2018).
Zukin and colleagues (2017) stated that para-nasal sinus mucoceles are benign cystic lesions originating from sinus mucosa that can impinge on adjacent orbital structures, causing ophthalmic sequelae such as decreased visual acuity (VA). Definitive treatment requires surgery. These investigators presented the first meta-analysis quantifying the effect of pre-operative visual function and time to surgery on post-operative VA outcomes. Data sources included PubMed, Ovid, Embase, Web of Science, and the Cochrane Library. Two independent authors systematically reviewed articles describing outcomes after ESS for para-nasal sinus mucoceles presenting with visual loss. Available data from case reports and series were combined to analyze the associations among pre-operative VA, time-to-surgery, and post-operative outcomes. A total of 85 studies were included that provided data on 207 patients. The average presenting VA was 1.57 logMAR (logarithm of the minimum angle of resolution), and the average post-operative VA was 0.21 logMAR, with visual improvement in 71.5 % of cases. Pre-operative VA of greater than or equal to 1.52 logMAR correlated with post-operative improvement greater than 1 logMAR (R = 0.4887, p < 0.0001). A correlation was found between a time-to-surgery of less than 6 days and post-operative improvement (R = 0.297, p < 0.0001). Receiver operator curve analysis of these thresholds demonstrated a moderately accurate prognostic ability (area under the curve: 75.1 for pre-operative VA and 73.1 for time-to-surgery). The authors concluded that visual loss resulting from para-nasal sinus mucoceles is potentially reversible in most cases, even those presenting with poor vision. When possible, surgery should be performed promptly after diagnosis, but emergency surgery did not appear to be necessary for vision restoration.
Yuca and co-workers (2006) stated that antro-choanal polyp (ACP) is a benign maxillary sinus polyp that originates from the mucosa of the maxillary sinus, passes through a sinus ostium, and extends into the choana. The common presentation of ACP is unilateral nasal obstruction. These investigators discussed radiographic findings and differential diagnosis of ACPs by comparing them with data in the literature. This study included 19 surgically treated patients with ACPs (14 male, 5 female; median age of 24.5 years, range of 8 to 75 years) diagnosed by clinical examination, nasal endoscopy, and CT. Nasal obstruction was found in all cases; ESS was preferred for removal of the nasal part of ACPs in 13 cases. Only in 1 case, polypectomy combined with Caldwell-Luc operation and septoplasty was performed. The observed complications were as follows: minor hemorrhage in 3 cases, mild cheek swelling with pain in 2 cases, and infra-orbital hypoesthesia in 1 case. Histopathologic examination of ACPs revealed loose mucoid stroma and mucous glands, which were covered by respiratory epithelium. The authors concluded that ESS may be indicated in patients with ACPs because the function and capacity of the maxillary antrum are preserved. The greater portion of the antral part of polyp could be removed while leaving the healthy antral mucosa intact.