Summary & Overview
CPT 31084: Frontal Sinus Obliteration, Open Frontal Sinus Surgery
CPT code 31084 represents an open frontal sinus obliteration procedure in which the surgeon accesses the frontal sinus through a brow incision, creates a bone flap, packs the sinus to render it nonfunctional, and replaces the flap. This procedure is used for refractory frontal sinus disease, complex frontal sinus fractures, or conditions where sinus preservation is not possible or safe. Nationally, this code matters because it captures a specialized, resource-intensive surgical intervention with implications for operative planning, inpatient resource use, and postoperative care.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical and billing overview of the procedure, expected site-of-service and service-line context, and what to expect in payer coverage patterns and billing complexity. The publication also outlines typical use cases, documentation considerations tied to the procedure description, and how the code relates to broader surgical service lines.
This summary equips clinicians, billing professionals, and policy analysts with a clear national-level depiction of CPT code 31084, highlighting its clinical purpose, typical care setting, and the payers commonly involved. Data not available in the input will be identified in detailed sections of the full publication.
Billing Code Overview
CPT code 31084 describes a surgical procedure to obliterate the frontal sinus via a brow incision with creation and replacement of a bone flap. The provider advances into the frontal sinus, creates a bone flap to expose the sinus contents, packs the sinus with material to obliterate it (rendering the sinus nonfunctional), and then repositions and sutures the flap.
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Service type: Surgical obliteration of the frontal sinus (open frontal sinus surgery)
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Typical site of service: Operating room or surgical suite, commonly performed by otolaryngology (head and neck) or craniofacial surgery teams under general anesthesia
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult referred to otolaryngology or craniofacial surgery for refractory frontal sinus disease following multiple failed endoscopic sinus surgeries, frontal sinus mucocele with bone erosion, chronic frontal sinusitis with persistent infection, or frontal sinus trauma with recurrent symptoms. The patient presents with frontal pain, recurrent purulent drainage, or a palpable mucocele and has imaging (CT of the sinuses) demonstrating opacification, bony expansion, or sinus obliteration not amenable to endoscopic repair. Preoperative workflow includes history and physical, review of CT imaging, medical optimization, informed consent discussing functional loss of the frontal sinus, perioperative antibiotics, and anesthesia evaluation.
Intraoperative workflow: the surgeon performs a brow (external) incision above the eyebrow, dissects to the frontal bone, creates a frontal sinus bone flap to expose the sinus cavity, evacuates diseased mucosa or mucocele contents, obliterates the sinus lumen by packing with autologous fat, muscle, or synthetic material to render the sinus nonfunctional, then replaces and sutures the bone flap and soft tissues. Typical procedure length varies with complexity. Postoperative care includes wound care, pain control, short course antibiotics as indicated, imaging follow-up, and clinic visits to monitor healing and resolution of infection or mass effect.
Typical site of service: hospital operating room or ambulatory surgical center for elective cases; urgent/emergent cases are usually performed in a hospital OR. Typical providers: otolaryngologists (ENT), facial plastic and reconstructive surgeons, and craniofacial surgeons.
Coding Specifications
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