© Copyright 2025 American Medical Association. All rights reserved.
Unilateral sinusotomy, as defined by CPT® Code 31090, involves surgical intervention on three or more of the paranasal sinuses, which include the frontal, maxillary, ethmoid, and sphenoid sinuses. The frontal sinuses are situated in the frontal bone, commonly referred to as the forehead, with one sinus located on each side of the midline. The maxillary sinuses are found within the maxilla, or cheekbones, also with a pair on either side. The ethmoid sinuses are located posterior to the nose and between the eyes, consisting of a collection of 6 to 12 small sinuses or cells on each side. The sphenoid sinus, the most posterior of the paranasal sinuses, is centrally positioned at the base of the skull, with one sinus on each side. Accessing these sinuses can be achieved through various surgical approaches. For the frontal sinuses, a transorbital approach is commonly utilized, while the maxillary sinuses can be accessed via an intranasal route or through the canine fossa intraorally. The ethmoid sinuses may be approached intranasally or extranasally. The sphenoid sinuses require one of three open approaches: transpalatal, transnasal transseptal, or external transorbital transethmoidal. During the procedure, three or more of these sinuses on one side (unilateral) are explored, allowing for the removal of purulent material, diseased tissue, or mucoceles, thereby alleviating symptoms associated with sinus disease.
© Copyright 2025 Coding Ahead. All rights reserved.
Unilateral sinusotomy is indicated for patients presenting with conditions affecting three or more of the paranasal sinuses, which may include:
The procedure for unilateral sinusotomy involves several key steps, which are detailed as follows:
Post-procedure care for patients undergoing unilateral sinusotomy typically includes monitoring for any complications, managing pain, and ensuring proper recovery. Patients may be advised to avoid strenuous activities and to follow specific instructions regarding nasal care and hygiene. Follow-up appointments are essential to assess healing and to determine if further interventions are necessary. Additionally, patients may be prescribed medications, such as antibiotics or nasal corticosteroids, to aid in recovery and prevent infection.
| Short Descr | EXPLORATION OF SINUSES | Medium Descr | SINUSOT UNI 3/> PARANSL SINUSES | Long Descr | Sinusotomy, unilateral, 3 or more paranasal sinuses (frontal, maxillary, ethmoid, sphenoid) | 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) | 1 - Statutory payment restriction for assistants at surgery applies 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. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 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) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.