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Otolaryngology Coding Alert

You Be the Coder:

Correct Code for Isshiki Type I Thyroplasty

Published on Mon Dec 15, 2014

Question: Several years ago, we were told to report 31599 for an Isshiki type I thyroplasty procedure because CPT® did not have a more specific code. Now Medicare and some other payers are denying our claims with 31599 even when we appeal with proof of medical necessity and other documentation. What should we be reporting? 

Idaho Subscriber 

Answer: Many practices code this service as 31588 (Laryngoplasty, not otherwise specified [e.g., for burns, reconstruction after partial laryngectomy]), because the descriptor is close to what your surgeon performs, but it’s not correct. Remember, you shouldn’t submit an existing CPT® code for a service just because it’s “close” to the procedure you’re reporting. 
 
Your better choice is 31599 (Unlisted procedure, larynx). Physician practices sometimes get frustrated when third-party payers don’t process “unlisted” codes correctly, but Medicare and other payers should process the claim correctly when you submit supporting documentation and are prepared to appeal if necessary.

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