What ICD-10 (International Classification of Diseases, 10th Revision) code is used to approve a CT (Computed Tomography) scan of the sinuses?

ICD-10 Codes for CT Sinus Approval

The specific ICD-10 code you use depends entirely on the clinical indication—chronic rhinosinusitis (J32.x series), recurrent acute rhinosinusitis (J01.x1), suspected complications (H05.x for orbital, G06.x for intracranial), suspected mass (J34.89 or D38.5), or suspected invasive fungal sinusitis (B44.x series) are the most appropriate codes that align with evidence-based indications for CT imaging.

Clinical Scenarios Where CT Sinus is Appropriate

Chronic Rhinosinusitis or Recurrent Acute Rhinosinusitis - Surgical Candidate

• J32.9 (Chronic sinusitis, unspecified) or specific codes like J32.0 (Chronic maxillary sinusitis), J32.1 (Chronic frontal sinusitis), J32.2 (Chronic ethmoidal sinusitis), or J32.3 (Chronic sphenoidal sinusitis) are appropriate when the patient is being evaluated for possible surgical intervention 1.
• CT paranasal sinuses without IV contrast is rated as "usually appropriate" (rating 9/9) for surgical planning in chronic rhinosinusitis, sinonasal polyposis, or noninvasive fungal sinusitis 1.
• J01.x1 codes (recurrent acute sinusitis) can be used for recurrent acute rhinosinusitis when surgery is being considered 1.

Suspected Orbital or Intracranial Complications

• H05.011-H05.019 (Cellulitis of orbit), H05.031-H05.039 (Subperiosteal abscess of orbit), or H05.041-H05.049 (Orbital abscess) for suspected orbital complications 1.
• G06.0 (Intracranial abscess), G06.2 (Extradural and subdural abscess), or G08 (Intracranial venous thrombosis) for suspected intracranial complications 1.
• CT paranasal sinuses without contrast is rated 7/9 ("usually appropriate") and CT with contrast is rated 8/9 when complications are suspected 1.
• MRI is complementary and often necessary for full evaluation of soft tissue involvement 1.

Suspected Sinonasal Mass

• J34.89 (Other specified disorders of nose and nasal sinuses) for benign suspected mass 1.
• D38.5 (Neoplasm of uncertain behavior of other respiratory organs) or C31.x series (Malignant neoplasm of accessory sinuses) if malignancy is suspected 1.
• CT paranasal sinuses without contrast is rated 8/9 ("usually appropriate") and is complementary to MRI for complete evaluation 1.

Suspected Invasive Fungal Sinusitis

• B44.0 (Invasive pulmonary aspergillosis) or B44.1 (Other pulmonary aspergillosis) can be adapted for sinonasal involvement 1.
• B46.x series (Zygomycosis/Mucormycosis) for suspected mucormycosis 1.
• CT paranasal sinuses without contrast is rated 8/9 and CT with contrast is also rated 8/9 ("usually appropriate") 1.
• This indication is critical in immunocompromised patients given the 50-80% mortality rate 1.

When CT Sinus is NOT Appropriate

Acute Uncomplicated Rhinosinusitis

• J01.x0 codes (acute sinusitis without recurrence) should NOT be used to justify CT imaging 1.
• CT imaging is rated only 4/9 ("may be appropriate") and clinical guidelines from the American Academy of Otolaryngology-Head and Neck Surgery explicitly state that imaging should not be obtained for uncomplicated acute rhinosinusitis 1.
• CT cannot distinguish bacterial from viral acute rhinosinusitis 1.

Non-Specific Symptoms Without Sinus Disease

• R06.7 (Sneezing), R19.6 (Halitosis), or R09.82 (Postnasal drip) alone are NOT appropriate indications 2.
• These symptoms do not meet criteria for sinus CT and lead to unnecessary radiation exposure with high rates (18-82%) of incidental findings in asymptomatic individuals 2.

Important Caveats

• Always document the specific clinical indication in your order—insurers will deny claims if you use J01.x0 (acute uncomplicated sinusitis) as the primary diagnosis 1.
• Specify laterality when using codes that require it (right, left, bilateral, or unspecified) 1.
• For surgical planning, document that medical management has been attempted or that the patient is being evaluated as a surgical candidate 1.
• CT without contrast is the standard protocol for most sinus imaging; contrast is reserved for suspected complications or invasive disease 1.
• Radiation exposure considerations: CT sinus delivers approximately 0.1-1 mSv of radiation, so the indication must be clinically justified 1.