CPT CODES

CPT Code 31382

CPT code 31382 is used for the procedure involving the partial removal of the larynx, often performed to treat certain throat conditions.

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What is CPT Code 31382

CPT code 31382 is used to describe a surgical procedure involving the partial removal of the larynx, also known as a partial laryngectomy. This procedure is typically performed to treat certain conditions such as laryngeal cancer, where only a portion of the larynx is affected and can be safely removed while preserving as much of the laryngeal function as possible. The goal of this surgery is to excise the diseased tissue while maintaining the patient's ability to speak and swallow, thereby improving their quality of life post-surgery.

Does CPT 31382 Need a Modifier?

For CPT code 31382, which involves the partial removal of the larynx, several modifiers may be applicable depending on the specific circumstances of the procedure. Here is a list of potential modifiers and their reasons for use:

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 complications or other factors that increase the complexity of the surgery.

2. Modifier 51 - Multiple Procedures: If the partial removal of the larynx is performed in conjunction with other procedures during the same surgical session, this modifier indicates that multiple procedures were performed.

3. Modifier 52 - Reduced Services: This modifier is applicable if the procedure was partially reduced or eliminated at the discretion of the physician. It indicates that the full service described by the CPT code was not performed.

4. Modifier 53 - Discontinued Procedure: If the procedure was started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient, this modifier should be used.

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. It is particularly relevant if the partial laryngectomy is performed in a different anatomical site or for a different reason than other procedures.

6. Modifier 62 - Two Surgeons: If two surgeons are required to perform distinct parts of the procedure, this modifier indicates that each surgeon is responsible for a specific portion of the surgery.

7. Modifier 66 - Surgical Team: When a complex procedure requires a surgical team, this modifier is used to indicate that multiple professionals are involved in the surgery.

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 modifier 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: If an unrelated procedure is performed by the same physician during the postoperative period of the initial surgery, this modifier is applicable.

These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. It is important to use them appropriately to reflect the specific details of the surgical intervention.

CPT Code 31382 Medicare Reimbursement

CPT code 31382, which involves a partial removal of the larynx, is subject to reimbursement by Medicare, but this is contingent upon several factors. The Medicare Physician Fee Schedule (MPFS) is a critical resource that determines the reimbursement rates for services covered under Medicare Part B. To ascertain if CPT code 31382 is reimbursed, healthcare providers should consult the MPFS to verify its inclusion and the associated payment rate.

Additionally, Medicare Administrative Contractors (MACs) play a pivotal role in the reimbursement process. MACs are responsible for processing Medicare claims and can provide specific guidance on coverage policies and local coverage determinations (LCDs) that may affect the reimbursement of CPT code 31382. Providers should check with their respective MAC to ensure compliance with any regional policies or documentation requirements that could impact reimbursement for this procedure.

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