CPT CODES

CPT Code 31360

CPT code 31360 is used for the surgical procedure involving the removal of the larynx, often necessary in treating certain throat conditions.

Accelerate your revenue cycle

Boost patient experience and your bottom line by automating patient cost estimates, payer underpayment detection, and contract optimization in one place.

Get a Demo

What is CPT Code 31360

CPT code 31360 is a medical billing code used to describe the surgical procedure for the removal of the larynx, also known as a total laryngectomy. This procedure involves the complete excision of the larynx, which is the organ responsible for voice production, located in the throat. It is typically performed to treat conditions such as laryngeal cancer or severe trauma to the larynx. The use of this specific CPT code ensures accurate billing and documentation for healthcare providers performing this complex surgical intervention.

Does CPT 31360 Need a Modifier?

For CPT code 31360, which involves the removal of the larynx, several modifiers may be applicable depending on the specific circumstances of the procedure. Here is a list of potential modifiers that could be used:

1. Modifier 22 - Increased Procedural Services: This modifier is used when the work required to perform the procedure is substantially greater than typically required. This could be due to factors such as increased complexity or time.

2. Modifier 51 - Multiple Procedures: If multiple procedures are performed during the same surgical session, this modifier indicates that more than one procedure was conducted.

3. Modifier 52 - Reduced Services: This modifier is applicable if the procedure was partially reduced or eliminated at the discretion of the physician.

4. Modifier 53 - Discontinued Procedure: Used when a procedure is started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.

5. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day.

6. Modifier 62 - Two Surgeons: If two surgeons are required to perform the procedure due to its complexity, this modifier is used to indicate the shared responsibility.

7. Modifier 66 - Surgical Team: When a highly complex procedure requires the skills of several physicians, this modifier indicates that a surgical team was involved.

8. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: This is used if the patient needs to return to the operating room for a related procedure during the postoperative period.

9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when an unrelated procedure is performed by the same physician during the postoperative period.

These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. It's important for healthcare providers to carefully assess the situation and apply the appropriate modifiers to reflect the services rendered accurately.

CPT Code 31360 Medicare Reimbursement

CPT code 31360 is reimbursed by Medicare, as it is included in the Medicare Physician Fee Schedule (MPFS). The MPFS is a comprehensive listing of fees used by Medicare to reimburse physicians and other healthcare providers for services rendered. However, the reimbursement for CPT code 31360 can vary based on several factors, including geographic location and specific contractual agreements.

Medicare Administrative Contractors (MACs) play a crucial role in determining the local coverage and payment policies for this code. MACs are responsible for processing Medicare claims and ensuring that the services billed are covered and reimbursed according to Medicare guidelines. Therefore, while CPT code 31360 is generally reimbursable under Medicare, healthcare providers should verify the specific reimbursement details with their respective MAC to ensure compliance and accurate payment.

Are You Being Underpaid for 31360 CPT Code?

Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and identifying underpayments down to the CPT code level, including specific codes like 31360. Schedule a demo today to see how RevFind can help you ensure full reimbursement from each payer.

Get paid in full by bringing clarity to your revenue cycle

Full Page Background