CPT® Code 31243

The procedure described by CPT® Code 31243 involves a surgical nasal and sinus endoscopy that specifically targets the destruction of the posterior nasal nerve (PNN) through cryoablation. This intervention is primarily indicated for patients suffering from chronic rhinorrhea, which is characterized by excessive mucus production due to a hyperactive PNN. This condition is often referred to as intractable vasomotor rhinitis. The goal of the procedure is to denervate the mucosa, thereby alleviating the nasal symptoms associated with this condition. During the procedure, a small endoscopic camera is utilized to provide visualization of the nasal cavity, allowing for precise intervention. Local anesthesia is administered through the use of surgical cotton wads that are soaked in a decongestant and anesthetic, which are strategically placed in various areas of the nasal cavity to ensure effective numbing. Following this, an intranasal anesthetic and vasoconstrictive agent are injected to further enhance comfort. The procedure involves the introduction of a radiofrequency delivery device, which is designed to fit into the sphenopalatine regions and the inferior turbinate. This device applies low power radiofrequency energy to disrupt the nerve by generating heat in the targeted mucosal areas at the back of the nose. After completing the procedure on one side, the same steps are repeated on the opposite side. Additionally, the procedure can also involve the use of a hand-triggered cryotherapy device that employs nitrous oxide to achieve controlled freezing of the target mucosal areas, further contributing to the destruction of the PNN.