CPT code 31584 is a procedure for repairing and reconstructing the larynx, often involving the reduction and fixation of fractures.
CPT code 31584 is used to describe a surgical procedure known as laryngoplasty with fracture reduction and fixation. This procedure involves the surgical repair of the larynx, which may include the reduction of fractures and the stabilization of the laryngeal structure using fixation techniques. It is typically performed to address structural damage or deformities in the larynx, often resulting from trauma or other medical conditions, to restore normal function and improve the patient's ability to speak and breathe.
For CPT code 31584, which pertains to laryngoplasty with fracture reduction and fixation, 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 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 performed.
3. 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.
4. Modifier 62 - Two Surgeons: When two surgeons work together as primary surgeons performing distinct parts of a procedure, this modifier is applicable.
5. Modifier 76 - Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: This modifier is used when the same procedure is repeated by the same provider.
6. Modifier 77 - Repeat Procedure by Another Physician or Other Qualified Health Care Professional: This is used when the procedure is repeated by a different provider.
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 applicable if the patient needs to 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 is performed during the postoperative period of another procedure, but 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 requirements, as these can influence the use of modifiers.
To determine if CPT code 31584 is reimbursed by Medicare, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS) and consult with their regional Medicare Administrative Contractor (MAC). The MPFS is a comprehensive listing of fees used by Medicare to reimburse physicians and other healthcare providers for services rendered. Each year, the Centers for Medicare & Medicaid Services (CMS) updates the MPFS, which includes information on whether specific CPT codes are covered and the reimbursement rates.
The MACs are responsible for processing Medicare claims and can provide region-specific guidance on coverage and reimbursement for CPT codes. They may have additional local coverage determinations (LCDs) that affect whether a particular service is reimbursed in their jurisdiction.
For CPT code 31584, providers should verify its status on the current MPFS and consult their MAC to confirm if it is reimbursed by Medicare and to understand any specific billing requirements or documentation needed to ensure proper reimbursement.
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