Otolaryngology Coding Alert
Laryngotracheoplasty With Graft
Question: How should I bill for laryngotracheoplasty performed with a rib cartilage interposition graft?
North Dakota Subscriber
Answer: This session involves several complex procedures, which should be reported as 31582 (Laryngoplasty; for laryngeal stenosis, with graft or core mold, including tracheotomy), 31750 (Tracheoplasty; cervical) and 20910 (Cartilage graft; costochondral).
Bill the codes in this order, starting with the procedure assigned the highest number of relative value units (RVUs): 31582 (45.2 RVUs), 31750 (30.26 RVUs), 20910 (12.78 RVUs).
Because the procedures reimburse at such a high rate (even when reductions for having performed multiple procedures are taken into account), the physician's documentation should clearly indicate that the trachea and larynx were worked on separately during the session.
Note: No modifier is required unless your carrier wants to see modifier -51 (Multiple procedures) appended to all multiple procedures. In that case, attach modifier -51 to 31750 and 20910.
Otolaryngology Coding Alert
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