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The CPT® Code 31086 refers to a surgical procedure known as a nonobliterative frontal sinusotomy performed through a brow incision utilizing an osteoplastic flap. This procedure is specifically designed to access the frontal sinus, which is located behind the forehead, to treat conditions such as chronic sinusitis or other diseases affecting the sinus. The term "nonobliterative" indicates that the procedure aims to preserve the sinus's natural anatomy rather than permanently close it off. The approach begins with a seagull-shaped incision made just below the eyebrow, extending across the upper part of the nose and below the opposite eyebrow. This incision allows the surgeon to access the underlying tissues and the frontal bone. Following the incision, the surgeon elevates the soft tissues to expose the frontal bone, which is then carefully cut using an oscillating saw or drill to create an opening over the frontal sinus. The procedure involves the removal of any infected or diseased tissue, as well as the complete ablation of the mucosa lining the sinus. After the necessary tissue removal, the bone flap is repositioned and secured with plates and screws, and the soft tissues and skin are meticulously closed in layers to promote proper healing. This detailed approach ensures that the frontal sinus is adequately treated while maintaining its structural integrity.
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The procedure described by CPT® Code 31086 is indicated for various conditions affecting the frontal sinus. These may include:
The surgical steps for the nonobliterative frontal sinusotomy with an osteoplastic flap are as follows:
Post-procedure care following a nonobliterative frontal sinusotomy includes monitoring for any signs of complications such as infection or excessive bleeding. Patients are typically advised to rest and may be prescribed pain management medications to alleviate discomfort. Follow-up appointments are essential to assess healing and to ensure that the sinus is functioning properly. Patients may also receive instructions on nasal care and hygiene to support recovery and prevent future sinus issues. It is important for patients to adhere to their healthcare provider's recommendations during the recovery period to achieve optimal outcomes.
| Short Descr | REMOVAL OF FRONTAL SINUS | Medium Descr | SINUSOT FRNT NONOBLIT W/OSTPL FLAP BROW INC | Long Descr | Sinusotomy frontal; nonobliterative, with osteoplastic flap, brow incision | 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) | 0 - Co-surgeons not permitted for this procedure. | 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. | 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) |
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| Pre-1990 | Added | Code added. |
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