NCCI · CPT 31231 / 31237
Diagnostic nasal endoscopy (31231) + with biopsy (31237)
Diagnostic nasal endoscopy and endoscopy with biopsy cannot be billed together.
Column 1 code
31231
Column 2 code
31237
Modifier indicator
0 — No bypass allowed
Why this pair bundles
31237 includes the diagnostic exam.
Modifier-bypass policy
Modifier indicator: 0 — no modifier bypass is permitted for this pair under any circumstance.
No bypass. Report the more comprehensive code (31237 if biopsy).
Documentation requirements
- Report 31237 only when biopsy performed
Common clinical scenarios
- Sinus eval with biopsy of polyp
Frequently asked questions
Why does CMS bundle 31231 and 31237?
31237 includes the diagnostic exam.
What documentation supports separate billing?
Report 31237 only when biopsy performed.
When does this conflict typically arise?
Sinus eval with biopsy of polyp.
Sources
Catch NCCI 31231/31237 conflicts before submission
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