Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)

CPT 31231 is the billing code for "Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)". Diagnostic nasal endoscopy for evaluation of nasal cavity and sinuses

Medicare pays approximately $184.05 for CPT 31231 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 31231 has a total RVU of 2.28, broken down as: Work RVU 1.00, Practice Expense RVU 1.20, and Malpractice RVU 0.08. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 31231 include: Unilateral or bilateral documented; Findings documented; Areas examined documented; Patient response to procedure. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 31231: Diagnostic endoscopy only. Unilateral or bilateral Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 31231 include: 59 (Distinct procedural service when multiple procedures performed), 50 (Bilateral procedure), LT (Left side). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 31231 is Typically 10-15 minutes. Time-based codes require documentation of the actual time spent providing the service.