CPT code 31560 is a procedure for examining the larynx and removing part of the arytenoid cartilage to improve voice or breathing function.
CPT code 31560 is used to describe a laryngoscopy procedure with arytenoidectomy. This code is specifically for a surgical procedure where a healthcare provider examines the larynx (voice box) using a laryngoscope and removes one or both arytenoid cartilages. The arytenoid cartilages are small structures in the larynx that play a crucial role in vocal cord movement and voice production. This procedure is typically performed to address issues such as vocal cord paralysis or other conditions affecting the voice or breathing. The use of this code helps ensure accurate billing and documentation for the services provided.
For CPT code 31560, which involves a laryngoscopy with arytenoidectomy, the following modifiers may be applicable:
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 50 - Bilateral Procedure: If the procedure is performed on both sides of the body, this modifier should be used to indicate that it was a bilateral procedure.
3. Modifier 51 - Multiple Procedures: When multiple procedures are performed during the same surgical session, this modifier is used to indicate that more than one procedure was performed.
4. 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 often used to bypass National Correct Coding Initiative (NCCI) edits.
5. Modifier 76 - Repeat Procedure by Same Physician: If the same procedure is repeated by the same physician, this modifier is used to indicate that the procedure was repeated.
6. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when the procedure is repeated by a different physician.
7. 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 when a patient must return to the operating room for a related procedure during the postoperative period.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when a procedure performed during the postoperative period is unrelated to the original procedure.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement. Always verify with the latest coding guidelines and payer-specific policies, as requirements can vary.
The CPT code 31560 is subject to reimbursement by Medicare, but its coverage and payment are determined by several factors. The Medicare Physician Fee Schedule (MPFS) is a critical resource that outlines the reimbursement rates for services covered under Medicare Part B, including those represented by CPT codes. To determine if CPT code 31560 is reimbursed, healthcare providers should consult the MPFS to verify if the code is listed and to understand the specific payment rate associated with it.
Additionally, Medicare Administrative Contractors (MACs) play a significant role in the reimbursement process. MACs are responsible for processing Medicare claims and have the authority to make local coverage determinations (LCDs) that can affect whether a particular service, such as the one represented by CPT code 31560, is reimbursed in their jurisdiction. Providers should check with their respective MAC to ensure that there are no specific local policies or requirements that could impact the reimbursement of this code.
In summary, while CPT code 31560 can be reimbursed by Medicare, providers must verify its inclusion in the MPFS and consult their MAC for any local coverage guidelines that may apply.
Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and detecting underpayments down to the CPT code level, including specific codes like 31560. Schedule a demo today to see how RevFind can help you identify discrepancies with individual payers and ensure you're receiving the full reimbursement you deserve.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
