Healthcare providers use standardized language known as Current Procedural Terminology (CPT) codes to communicate medical services for billing and reimbursement. These codes translate specific medical procedures into a uniform set of numbers understood by insurance companies and government payers. Understanding these codes helps patients review their medical statements to ensure accuracy. CPT Code 31231 is a specific identifier corresponding to a common procedure used to investigate issues within the nose and sinuses.
The Definition of CPT Code 31231
CPT Code 31231 describes a “Nasal endoscopy, diagnostic; unilateral or bilateral (separate procedure).” This procedure uses a thin, rigid or flexible tube called an endoscope, equipped with a light source and a tiny camera. This allows a physician, typically an otolaryngologist, to visually examine the deep structures of the nasal cavity and the openings of the paranasal sinuses, offering visualization far beyond a standard nasal speculum examination.
The term “diagnostic” means the procedure is performed solely for observation and identifying the cause of symptoms, not for surgical correction or treatment. If the physician performs a therapeutic action, such as removing a polyp or controlling active bleeding, a different CPT code must be used.
The phrase “unilateral or bilateral” confirms the code covers the diagnostic examination of one or both sides of the nasal cavity. The designation “separate procedure” indicates the service is only reported when it is not an inherent part of a more extensive procedure performed on the same day.
Medical Reasons for the Procedure
A diagnostic nasal endoscopy is indicated when persistent symptoms cannot be fully evaluated through a less invasive physical examination. The direct visualization helps the physician assess inflammation, the presence of pus, and the condition of the sinus drainage pathways.
The procedure is used for several key diagnostic purposes:
- Evaluating chronic sinonasal symptoms, such as persistent nasal congestion, facial pressure, or thick post-nasal drip that has not responded to initial treatments.
- Investigating unexplained or recurrent nosebleeds (epistaxis), allowing the physician to precisely locate the source of bleeding.
- Evaluating suspected masses or growths, such as nasal polyps or tumors, that may be causing an obstruction.
- Looking for physical obstructions that might be blocking the olfactory region in patients reporting a diminished or complete loss of their sense of smell (hyposmia or anosmia).
- Monitoring patients who have undergone prior nasal or sinus surgery to check for healing, recurrence of disease, and ensure the sinuses remain open.
What the Patient Experience Involves
The diagnostic nasal endoscopy is typically performed in a clinic or office setting, and the patient remains awake throughout the brief procedure. Preparation begins with applying a topical decongestant spray, which shrinks the mucous membranes to create more space and improve visibility. Following this, a local anesthetic spray is applied to numb the inside of the nose and minimize discomfort.
The procedure itself is quite fast, usually lasting between 5 and 15 minutes. The patient sits upright in an exam chair while the physician gently inserts the lubricated endoscope into one nostril. The physician then carefully advances the scope, viewing the images on an external monitor to examine the structures of the nasal cavity and sinuses.
While the procedure should not be painful, patients often report a feeling of pressure as the scope navigates the nasal passages. The topical anesthetic may cause a temporary numbing sensation in the back of the throat, which can feel unusual but quickly resolves. After the scope is withdrawn, patients generally have minimal recovery time and can resume their normal daily activities immediately.