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Obliterative frontal sinusotomy, as described by CPT® Code 31081, is a surgical procedure aimed at addressing issues related to the frontal sinus, particularly in cases where other treatments have failed. This procedure is less commonly performed today but may still be indicated for patients suffering from intractable frontal sinusitis, complications arising from previous surgical interventions, or conditions such as mucopyocele. The technique involves a coronal incision, which is made along the hairline, allowing access to the frontal sinus without the use of an osteoplastic flap. The primary goal of this surgery is to obliterate the frontal sinus, effectively preventing the recurrence of sinus-related issues by removing the sinus mucosa and filling the sinus cavity with abdominal fat. This approach is particularly relevant for patients who have not responded to endoscopic treatments or have experienced late complications from prior open obliteration procedures. The procedure includes the use of a burr to access the sinus and the complete ablation of the mucosa, ensuring that the sinus is thoroughly treated to mitigate future problems.
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The obliterative frontal sinusotomy procedure, coded as CPT® 31081, is indicated for specific conditions and scenarios where other treatment options have proven ineffective. The following are the explicitly provided indications for this procedure:
The obliterative frontal sinusotomy procedure involves several critical steps to ensure effective treatment of the frontal sinus. The following procedural steps are outlined:
After the obliterative frontal sinusotomy procedure, patients can expect a recovery period that may involve specific post-operative care. It is essential to monitor for any signs of complications, such as infection or excessive bleeding. Patients may be advised to avoid strenuous activities and follow up with their healthcare provider for assessments of healing and any necessary interventions. Pain management and instructions for wound care will also be provided to ensure a smooth recovery process. The overall goal of post-procedure care is to facilitate healing and prevent any recurrence of the conditions that necessitated the surgery.
| Short Descr | REMOVAL OF FRONTAL SINUS | Medium Descr | SINUSOT FRNT OBLIT W/O OSTPL FLAP CORONAL INC | Long Descr | Sinusotomy frontal; obliterative, without osteoplastic flap, coronal incision (includes ablation) | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 33 - Other OR therapeutic procedures on nose, mouth and pharynx |
| 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| Pre-1990 | Added | Code added. |
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