How To Use CPT Code 31584

CPT 31584 describes the surgical repair or alteration of the larynx to fix a fracture, which may include a tracheostomy. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 31584?

CPT 31584 is used to describe a surgical procedure that involves repairing or altering the larynx to fix a fracture. This may include performing a tracheostomy, which is the creation of an artificial opening in the trachea to assist with breathing during the procedure. The fracture of the larynx can occur due to various causes such as motor vehicle accidents, sports injuries, or assaults.

2. Official Description

The official description of CPT code 31584 is: ‘Laryngoplasty; with open reduction and fixation of (eg, plating) fracture, includes tracheostomy, if performed.’ This code also notes that the graft should not be reported separately if it is harvested through the laryngoplasty incision, such as a thyroid cartilage graft.

3. Procedure

1. The provider begins by preparing and anesthetizing the patient.
2. If necessary, a tracheostomy is performed first, creating an artificial opening in the trachea to aid in breathing during the procedure.
3. An incision is made on the neck to access the cricoid and laryngeal cartilage, with careful separation and retraction of muscle and tissue.
4. Depending on the type of injury, the provider may make an incision through the thyrohyoid membrane or the thyroid cartilage over the larynx to reach the fractured area.
5. The provider then manipulates the laryngeal tissues to realign them and uses wire sutures or miniplates to stabilize the structure.
6. Afterwards, the muscle and tissue are reapproximated, and the incision is closed. A nasogastric tube may be placed if necessary.

4. Qualifying circumstances

CPT 31584 is used when a patient has a fracture of the larynx that requires surgical repair. The procedure is performed by a qualified healthcare provider who has the necessary expertise in laryngoplasty. The tracheostomy, if performed, is included in this code. It is important to note that if a graft is harvested through the laryngoplasty incision, it should not be reported separately.

5. When to use CPT code 31584

CPT code 31584 should be used when a surgical repair or alteration of the larynx is performed to fix a fracture. This code is appropriate when the provider performs an open reduction and fixation of the fracture, which may involve the use of plates or other fixation devices. If a tracheostomy is also performed during the procedure, it is included in this code.

6. Documentation requirements

To support a claim for CPT 31584, the provider must document the following information:

• The diagnosis indicating the need for laryngeal fracture repair
• Details of the procedure performed, including the approach used and any fixation devices utilized
• Documentation of any tracheostomy performed, if applicable
• Date of the procedure
• Any additional relevant information or complications encountered during the procedure
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 31584, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The provider should be qualified and experienced in performing laryngoplasty procedures. If a tracheostomy is performed as part of the procedure, it should not be reported separately. It is also important to follow any additional guidelines or requirements set forth by the payer or insurance company.

8. Historical information

CPT 31584 was added to the Current Procedural Terminology system on January 1, 1990. There have been some changes to the code over the years, including updates to the code description and the addition of notes regarding graft reporting.

9. Examples

1. A patient sustains a laryngeal fracture due to a motor vehicle accident. The provider performs laryngoplasty with open reduction and fixation of the fracture, including a tracheostomy.
2. An individual experiences a sports-related injury resulting in a fractured larynx. The provider performs laryngoplasty with open reduction and fixation of the fracture, without the need for a tracheostomy.
3. A patient presents with a laryngeal fracture caused by an assault. The provider performs laryngoplasty with open reduction and fixation of the fracture, including a tracheostomy and the use of a graft harvested through the laryngoplasty incision.
4. Due to a blunt injury, a patient suffers a fractured larynx. The provider performs laryngoplasty with open reduction and fixation of the fracture, without the need for a tracheostomy.
5. An individual sustains a laryngeal fracture during an assault. The provider performs laryngoplasty with open reduction and fixation of the fracture, including a tracheostomy and the use of a graft harvested through the laryngoplasty incision.