How To Use CPT Code 31086

CPT 31086 describes a specific procedure known as sinusotomy frontal. This article will provide an overview of the code, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes to CPT 31086.

1. What is CPT Code 31086?

CPT 31086 is a code used to describe a surgical procedure called sinusotomy frontal. This procedure involves making an incision in the brow area to gain access to the frontal sinus. The provider then removes diseased tissues from the frontal sinus, such as benign neoplasms or polyps. Afterward, the frontal bone flap is repositioned and secured with sutures.

2. Official Description

The official description of CPT code 31086 is: ‘Sinusotomy frontal; nonobliterative, with osteoplastic flap, brow incision.’

3. Procedure

1. The provider begins by making an incision in the brow area, below the middle of the eyebrow and supraorbital rim of the eye.
2. Through this incision, the provider gains access to the frontal sinus by resecting the periosteum flap of the frontal bone.
3. The diseased tissues within the frontal sinus, such as benign neoplasms or polyps, are then removed.
4. The periosteum flap is carefully sutured back into its original position.
5. In some cases, a catheter may be inserted for further irrigation and drainage.

4. Qualifying circumstances

CPT 31086 is used when a patient requires surgical removal of diseased tissues from the frontal sinus. This procedure is typically performed to address conditions such as benign tumors or polyps. The patient must be appropriately prepped and anesthetized for the procedure. The provider must also make a brow incision and resect the periosteum flap of the frontal bone to gain access to the frontal sinus.

5. When to use CPT code 31086

CPT code 31086 should be used when a provider performs a nonobliterative frontal sinusotomy with an osteoplastic flap and brow incision. It is important to note that this code represents a unilateral service, meaning it is performed on one side. If the procedure is performed bilaterally, modifier 50 should be appended to the code or modifiers RT/LT can be used, depending on payer preference.

6. Documentation requirements

To support a claim for CPT 31086, the provider must document the following information:

• Patient’s diagnosis necessitating the frontal sinusotomy
• Details of the procedure, including the brow incision and resection of the periosteum flap
• Description of the diseased tissues removed from the frontal sinus
• Any additional procedures performed, such as catheter insertion for irrigation and drainage
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 31086, ensure that the procedure meets the specific criteria outlined in the code description. It is important to use the appropriate modifiers if the procedure is performed bilaterally or if the payer requires the use of RT/LT modifiers. Additionally, be aware of any specific payer guidelines or requirements for reporting CPT 31086.

8. Historical information

CPT 31086 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 provider performs a sinusotomy frontal on a patient with a benign neoplasm in the frontal sinus, using a brow incision and resecting the periosteum flap.
2. During a frontal sinusotomy, the provider removes polyps from the frontal sinus of a patient, securing the frontal bone flap with sutures.
3. A surgical team performs a nonobliterative frontal sinusotomy on a patient with a benign tumor, utilizing a brow incision and repositioning the frontal bone flap.
4. A provider performs a sinusotomy frontal on a patient with diseased tissues in the frontal sinus, using a brow incision and carefully suturing the periosteum flap back into place.
5. During a frontal sinusotomy, the provider removes a benign neoplasm from the frontal sinus, securing the frontal bone flap with sutures.
6. A surgical team performs a nonobliterative frontal sinusotomy on a patient with polyps in the frontal sinus, utilizing a brow incision and repositioning the frontal bone flap.
7. A provider performs a sinusotomy frontal on a patient with a benign tumor in the frontal sinus, using a brow incision and carefully suturing the periosteum flap back into place.
8. During a frontal sinusotomy, the provider removes diseased tissues from the frontal sinus of a patient, securing the frontal bone flap with sutures.
9. A surgical team performs a nonobliterative frontal sinusotomy on a patient with polyps in the frontal sinus, utilizing a brow incision and repositioning the frontal bone flap.
10. A provider performs a sinusotomy frontal on a patient with a benign neoplasm in the frontal sinus, using a brow incision and carefully suturing the periosteum flap back into place.