Ace FESS Coding Updates With This Quick Terminology Quiz

CPT® 2018 introduced several changes for nasal/sinus endoscopy codes, sometimes referred to as FESS codes. Otolaryngology coders need some real anatomy-terminology skills to apply these codes correctly, so here’s your chance to sharpen your knowledge.

Look at the terms below. In some cases, you’ll see a related code tied to the term to help show how the term and coding connect. Match the term to the proper definition, and then check your answers at the end.

Ready, Set, Go Match These Terms!

1. Ethmoidectomy

Code example: 31253 (Nasal/sinus endoscopy, surgical with ethmoidectomy …)


3. Frontal sinuses

Code example: 31253 (… total (anterior and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when performed)

4. Sphenoid sinuses

Code example: 31259 (… total (anterior and posterior), including sphenoidotomy, with removal of tissue from the sphenoid sinus)

5. Ligation

Code example: 31241 (Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery)

6. Ostia

Code example: 31298 (… with dilation of frontal and sphenoid sinus ostia (eg, balloon dilation))

7. Sphenoidotomy

Code example: 31257 (Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy)

8. Sphenopalatine artery

Code example: 31241 (Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery)

Find Your Definitions Here

A. Two large cavities in the bone that forms the lower part of the forehead

B. Functional endoscopic sinus surgery; a surgical procedure in which the provider inserts an endoscope into the nose for a direct visual examination of the openings into the sinuses and removal of tissues that are infected or are causing obstruction

C. A surgical procedure that involves tightly tying a cord or thread around a tube or duct in the body

D. A surgical procedure to remove tissue between the ethmoid sinuses near the bridge of the nose to allow for improved drainage

E. Sinuses located near the center of the skull in the upper back wall of the nasal cavity

F. A branch of the internal maxillary artery; it provides blood to the nasal cavity

G. A surgical procedure that creates an opening in the wall of the sphenoid sinus

H. Small openings, such as into a body cavity or vessel

Compare Your Choices to the Correct Solutions

  1. D
  2. B
  3. A
  4. E
  5. C
  6. H
  7. G
  8. F


What About You?

How did you do on the terms? And how have you been doing applying the codes? Some coders are reporting trouble determining how to report the codes when a patient has a procedure that involves three or more sinuses. How are you handling these cases?


Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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