How To Use CPT Code 31085

CPT 31085 describes a specific procedure known as obliterative frontal sinusotomy with osteoplastic flap, performed through a coronal incision. This article will provide an overview of CPT code 31085, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 31085?

CPT 31085 is a code used to describe the obliterative frontal sinusotomy procedure with osteoplastic flap. This procedure involves making a coronal incision and accessing the frontal sinus. The provider then removes the tissues within the sinus, packs it with material to obliterate it, and repositions the frontal bone flap with sutures.

2. Official Description

The official description of CPT code 31085 is: ‘Sinusotomy frontal; obliterative, with osteoplastic flap, coronal incision.’

3. Procedure

1. The provider begins by making a coronal incision across the top of the scalp, usually above the ears.
2. They then incise the periosteum and raise an osteoplastic flap, preserving it.
3. Through this flap, the provider enters the frontal sinus and removes all mucosa and tissues present.
4. The sinus is then packed with material, such as abdominal fat, to obliterate it and the passages to the nose are plugged.
5. The provider repositions the flap and secures it with sutures.
6. Finally, the coronal incision is closed with sutures in layers.

4. Qualifying circumstances

Obliterative frontal sinusotomy with osteoplastic flap is typically performed on patients with recurrent infections, cancer, or injuries affecting the frontal sinus. It is important to note that this procedure should only be performed by a qualified healthcare professional with the necessary expertise.

5. When to use CPT code 31085

CPT code 31085 should be used when the provider performs an obliterative frontal sinusotomy with osteoplastic flap through a coronal incision. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT code 31085, the provider must document the following information:

• Patient’s diagnosis and the medical necessity for the procedure
• Details of the procedure performed, including the use of a coronal incision and osteoplastic flap
• Date of the procedure
• Any additional relevant information or complications encountered during the procedure
• Signature of the performing provider

7. Billing guidelines

When billing for CPT code 31085, it is important to ensure that the procedure meets the specific criteria outlined in the code description. Additionally, providers should follow any specific billing guidelines provided by their payer. It is also important to note that CPT code 31085 should not be reported with other codes unless specifically indicated by the payer.

8. Historical information

CPT code 31085 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with recurrent frontal sinus infections undergoes obliterative frontal sinusotomy with osteoplastic flap to alleviate symptoms and prevent further infections.
2. A patient with frontal sinus cancer requires obliterative frontal sinusotomy with osteoplastic flap as part of their treatment plan.
3. An individual sustains a severe injury to the frontal sinus and undergoes obliterative frontal sinusotomy with osteoplastic flap to repair the damage.
4. A patient with a history of chronic frontal sinusitis undergoes obliterative frontal sinusotomy with osteoplastic flap to improve their quality of life.
5. A provider performs obliterative frontal sinusotomy with osteoplastic flap on a patient with a congenital abnormality affecting the frontal sinus.