Summary & Overview
CPT 31087: Frontal Sinus Osteoplastic Flap and Excision
CPT code 31087 represents an open frontal sinus procedure in which a coronal scalp incision and an osteoplastic frontal bone flap are used to access and excise diseased frontal sinus tissue, followed by repositioning and suturing of the bone flap. This procedure is clinically significant for treating frontal sinus disease such as benign neoplasms, mucoceles, or refractory inflammatory pathology that cannot be managed endoscopically. Nationally, accurate coding for complex skull-base and sinus procedures affects hospital resource planning, surgical quality reporting, and appropriate reimbursement for high-acuity otolaryngology and neurosurgical services.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find guidance on the clinical context and service setting for CPT code 31087, common payer coverage considerations, and the types of benchmarks and policy topics typically relevant to this code. The publication outlines expected site-of-service patterns, implications for inpatient versus outpatient billing, and points of emphasis for documentation and claim adjudication. Data not available in the input are noted where applicable; the narrative focuses on national relevance, clinical indications, and the administrative factors that influence use of CPT code 31087.
Billing Code Overview
CPT code 31087 describes an open surgical procedure on the frontal sinus. The surgeon makes a coronal incision across the top of the scalp, creates an osteoplastic flap of the frontal bone, excises diseased frontal sinus tissue (for example, benign neoplasm or polyp), and then repositions and secures the frontal bone flap with sutures.
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Service type: Open frontal sinus surgery with osteoplastic flap and excision of disease
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Typical site of service: Operating room, inpatient or outpatient surgical setting depending on clinical indication and postoperative needs
Clinical & Coding Specifications
Clinical Context
A 54-year-old male presents with chronic frontal sinus disease characterized by recurrent infection, persistent mucopurulent drainage, and a frontal sinus mucosal polyp demonstrated on CT. Conservative medical therapy including antibiotics and endoscopic intervention failed to resolve symptoms. The patient is evaluated preoperatively with CT sinus imaging and routine pre-op labs. Under general anesthesia in an operating room, the surgeon makes a coronal scalp incision, raises an osteoplastic flap of the frontal bone, excises the diseased frontal sinus mucosa and any benign neoplasm or polyp, irrigates and inspects the sinus, then repositions and secures the bone flap with sutures or plates before layered closure. Typical perioperative workflow includes pre-op anesthesia evaluation, intraoperative specimen submission (if indicated), postoperative recovery in PACU, discharge instructions for wound care, and follow-up for healing and sinonasal function assessment. Typical site of service is an inpatient or outpatient hospital operating room; ambulatory surgery center use is possible depending on patient comorbidities and facility capabilities. Typical service type: open frontal sinus surgery (osteoplastic flap) for definitive removal of diseased tissue or benign lesions of the frontal sinus.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — default billing | Use as the base submission when no specific modifier applies |