Blue Cross of Idaho Logo

Express Sign-on

Thank you for registering with Blue Cross of Idaho

If you are an Individual or Family Member under age 65, please register here.

If you are an Medicare or Medicare Supplement member, please register here.

New Options for Affordable Health Insurance

 

Sinus Surgery

last updated 02/06/2013garcarl

21685 Hyoid myotomy and suspension
30120 Excision or surgical planing of skin of nose for rhinophyma
30400 Rhinoplasty, primary, lateral and alar cartilages and/or elevation of nasal tip
30410 Rhinoplasty, primary; complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip
30420 Rhinoplasty, primary; including major septal repair
30520 Septoplasty W/Wo Cartilage Implant
31020 Sinusotomy Maxilla (Antrotomy) Intranasa   
31030 Sinusotomy, maxillary (antrotomy); radical (Caldwell-Luc) without removal of antrochoanal polyps
31032 Sinusotomy, maxillary (antrotomy); radical (Caldwell-Luc) with removal of antrochoanal polyps
31040 Pterygomaxillary fossa surgery, any approach
31050 Sinusotomy, sphenoid, with or without biopsy;
31051 Sinusotomy, sphenoid, with or without biopsy; with mucosal stripping or removal of polyp(s)
31070 Sinusotomy frontal; external, simple (trephine operation)
31075 Sinusotomy frontal; transorbital, unilateral (for mucocele or osteoma, Lynch type)
31080 Sinusotomy frontal; obliterative without osteoplastic flap, brow incision (includes ablation)
31081 Sinusotomy frontal; obliterative, without osteoplastic flap, coronal incision (includes ablation)
31084 Sinusotomy frontal; obliterative, with osteoplastic flap, brow incision
31085 Sinusotomy frontal; obliterative, with osteoplastic flap, coronal incision
31086 Sinusotomy frontal; nonobliterative, with osteoplastic flap, brow incision
31087 Sinusotomy frontal; nonobliterative, with osteoplastic flap, coronal incision
31090 Sinusotomy, unilateral, three or more paranasal sinuses (frontal, maxillary, ethmoid, sphenoid)
31200 Ethmoidectomy Intranasal Anterior     
31201 Ethmoidectomy Intranasal Total
31205 Ethmoidectomy Extranasal Total
31225 Maxillectomy Wo Orbit Exenteration  
31230 Maxillectomy; with orbital exenteration (en bloc)
31237 Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)
31239 Nasal/sinus endoscopy, surgical; with dacryocystorhinostomy
31240 Nasal/sinus endoscopy, surgical; with concha bullosa resection
31254 Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial (anterior)
31255 Nasal/sinus endoscopy, surgical; with ethmoidectomy, total (anterior and posterior)
31256 Nasal/sinus endoscopy, surgical, with maxillary antrostomy;
31267 Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus
31276 Nasal/sinus endoscopy, surgical with frontal sinus exploration, with or without removal of tissue from frontal sinus
31287 Nasal/sinus endoscopy, surgical, with sphenoidotomy;
31288 Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from the sphenoid sinus
31295 Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa 
31296 Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation) 
31297 Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation) 
41512 Tongue base suspension; permanent suture technique
42140 Uvulectomy, excision of uvula
42145 Uvulopalatopharyngoplasty

If you are already securely logged in and would like to submit your request online click on “Authorization Submission.”
To login/enroll in our online “Authorization Submission,” please click hyperlink.
If you would like a .pdf version of our prior authorization form, please click here.