Drug-Eluting Sinus Implant (Codes 0406T, 0407T) (February 2016)

February 2016 pages 10-11 Drug-Eluting Sinus Implant (Codes 0406T, 0407T) For the 2016 CPT® code set, two new Category III codes were established to describe the placement of a drug-eluting ethmoid sinus implant. This article will address the appropriate reporting of these procedures. New codes 0406TNasal endoscopy, surgical, ethmoid sinus, placement of drug eluting implant; 0407Twith biopsy, polypectomy or debridement (Do not report 0406T, 0407T in conjunction with 31200, 31201, 31205, 31231, 31237, 31240, 31254, 31255, 31288, 31290 when performed on the same side) (Do not report 0407T in conjunction with 0406T if performed on the same side) Codes...

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Note:  The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.

Article Overview

This February 2016 CPT Assistant article explains reporting considerations for a drug-eluting sinus implant article focused on ethmoid sinus endoscopy. It is intended for coders, billers, and clinicians who need to understand the scope of the new Category III codes, related parenthetical notes, and how the article frames associated endoscopic sinus procedures. The content also places the discussion in the context of procedure reporting, unlisted service reporting, and payer-specific guidance.

Why This Topic Matters

Accurate understanding of this article helps readers identify when the new CPT Category III guidance applies and how the article positions it among related sinus endoscopy services and coding references.

Article Sections

  1. New codes

    Introduces the new CPT Category III reporting topics discussed in the article and frames the general scope of the implant-related guidance.

  2. Clinical Example (0406T)

    Presents a representative scenario tied to one of the new codes and is paired with procedure-oriented discussion.

  3. Description of Procedure (0406T)

    Summarizes the procedure workflow associated with the first implant-related code in broad terms.

  4. Clinical Example (0407T)

    Presents a representative scenario tied to the second new code and is paired with procedure-oriented discussion.

  5. Description of Procedure (0407T)

    Summarizes the procedure workflow associated with the second implant-related code in broad terms.

What You Will Learn

  • How the article situates new Category III CPT reporting guidance for a sinus implant procedure
  • What types of related endoscopic sinus services are discussed alongside the implant topic
  • How the article frames procedure examples and procedural descriptions for each new code
  • What general reporting context is provided for same-session and related-service considerations

Who Should Read This

  • Medical coders
  • Coding auditors
  • Physician practices
  • ENT specialists
  • Billing staff

Codes Discussed

Modifiers Discussed


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