CPT code 31720 is used for procedures involving the clearance of airways, ensuring proper respiratory function in patients.
CPT code 31720 is used to describe a medical procedure involving the clearance of airways. This code is typically applied when a healthcare provider performs a procedure to remove obstructions or secretions from a patient's airways, which can include techniques such as suctioning or other methods to ensure that the air passages are clear and the patient can breathe more easily. This procedure is often necessary in cases where patients have respiratory issues that impede normal breathing, and it is crucial for maintaining adequate ventilation and oxygenation.
For CPT code 31720, "Clearance of airways," the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly more work than typically required. This could be due to complications or additional effort needed to clear the airways.
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 bilateral.
3. Modifier 51 - Multiple Procedures: When multiple procedures are performed during the same session, this modifier is used to indicate that more than one procedure was conducted.
4. Modifier 52 - Reduced Services: If the procedure was partially reduced or eliminated at the discretion of the physician, this modifier should be applied.
5. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that the procedure was distinct or independent from other services performed on the same day.
6. Modifier 76 - Repeat Procedure by Same Physician: If the same procedure is repeated by the same physician, this modifier should be used.
7. Modifier 77 - Repeat Procedure by Another Physician: If the procedure is repeated by a different physician, this modifier is applicable.
8. Modifier 78 - Unplanned Return to the Operating/Procedure Room: Use this modifier if the patient returns 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 a procedure is performed during the postoperative period of another procedure, but is unrelated to the original procedure.
10. Modifier 80 - Assistant Surgeon: If an assistant surgeon is required for the procedure, this modifier should be used.
11. Modifier 81 - Minimum Assistant Surgeon: Use this modifier when a minimum assistant surgeon is required.
12. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is necessary due to the unavailability of a qualified resident surgeon.
13. Modifier 99 - Multiple Modifiers: If more than four modifiers are necessary to describe the procedure, this modifier is used to indicate the presence of multiple modifiers.
Each modifier should be used in accordance with the specific circumstances of the procedure and payer requirements. Proper documentation is essential to support the use of any modifier.
The CPT code 31720 is subject to reimbursement by Medicare, but its coverage and payment are determined by several factors, including its inclusion in the Medicare Physician Fee Schedule (MPFS) and the policies set by the local Medicare Administrative Contractor (MAC).
The MPFS provides a comprehensive list of services covered by Medicare, along with the associated payment rates. However, the final decision on reimbursement can vary based on the MAC's local coverage determinations (LCDs) and any specific billing guidelines they may have in place.
Therefore, healthcare providers should verify the reimbursement status of CPT code 31720 with their respective MAC to ensure compliance with local Medicare policies.
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 31720. 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
