CPT® Code 31288

A surgical nasal/sinus endoscopy with sphenoidotomy is a specialized procedure that involves the examination and treatment of the sphenoid sinus, which is located behind the nose and between the eyes. This procedure is performed using an endoscope, a thin, flexible tube equipped with a camera and light, allowing the physician to visualize the nasal cavity and paranasal sinuses in detail. Prior to the procedure, a topical nasal decongestant and a local anesthetic with a vasoconstrictor may be applied to minimize discomfort and reduce bleeding during the surgery. The endoscope is introduced through the nostrils, enabling the surgeon to inspect the nasal passages for any signs of disease or abnormalities. In the context of CPT® Code 31288, the procedure specifically involves a sphenoidotomy, which is the surgical opening of the sphenoid sinus. This is achieved through various approaches, such as a medial or lateral approach to the middle turbinate, or through the removal of the middle turbinate itself. Once the endoscope is in place, the surgeon may push the middle turbinate laterally to gain access to the superior turbinate, where a probe is used to locate the sphenoid ostium. The lower third of the superior turbinate may be removed to facilitate access to the sphenoid sinus, which is then opened and enlarged to allow for proper drainage. Following the sphenoidotomy, the procedure includes the removal of diseased tissue from the sphenoid sinus. This is typically accomplished using a microdebrider, a surgical instrument designed to cut and suction away tissue, ensuring that any infected or abnormal tissue lining the sinus is effectively removed. This comprehensive approach not only aids in alleviating symptoms associated with sinus disease but also helps in obtaining specimens for culture and sensitivity testing, which can guide further treatment options.