Summary & Overview
CPT 31551: Pediatric Laryngoplasty via Tracheotomy, Cartilage Graft
CPT code 31551 denotes a pediatric laryngoplasty performed in children under 12 years using a tracheotomy to access the larynx, with dilation or web release as needed and placement of a cartilage graft to correct laryngeal stenosis. This procedure addresses significant airway narrowing that can impair breathing and voice, making it a high-acuity surgical service in pediatric otolaryngology.
Key national payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare and Medicare. The publication outlines how CPT code 31551 is used in clinical practice, typical sites of service, and the clinical indications that drive use of the code. It also summarizes common modifiers associated with surgical services when applicable.
Readers will find concise benchmarks and coding context for CPT code 31551, including clinical rationale for the procedure, expected care settings, and payer coverage considerations. The piece highlights the code’s role in managing pediatric laryngeal stenosis and what payers generally evaluate for authorization and reimbursement decisions. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 31551 describes a laryngoplasty in a child younger than 12 years, performed using a tracheotomy to access the larynx. The procedure includes dilation and release of webs as needed and placement of a cartilage graft on the larynx to stabilize the larynx and trachea and to correct laryngeal stenosis or narrowing.
Service Type: Surgical airway reconstruction for pediatric laryngeal stenosis
Typical Site of Service: Operating room or pediatric surgical suite with tracheostomy access, typically in a hospital inpatient or ambulatory surgical center setting depending on clinical context and postoperative needs.
Clinical & Coding Specifications
Clinical Context
A 9-year-old child with symptomatic subglottic laryngeal stenosis following prolonged neonatal intubation presents with progressive stridor, exercise intolerance, and impaired phonation. The multidisciplinary airway team (pediatric otolaryngologist, pediatric anesthesiologist, and pediatric intensive care specialists) evaluates the child with awake flexible laryngoscopy and bronchoscopy under anesthesia to define the level and severity of stenosis. The child already has a secure tracheotomy tube in place to protect the airway and provide ventilation.
Operative workflow: After induction of general anesthesia through the tracheotomy, the surgeon performs direct laryngoscopy and bronchoscopy, dilates and releases anterior and/or posterior laryngeal webs or scar as needed, and fashions and secures a cartilage graft (commonly costal cartilage) to expand and stabilize the subglottic airway and laryngeal framework. Intraoperative neuromonitoring may be used per institutional protocol. The tracheotomy is maintained postoperatively for airway protection, humidification, and pulmonary toilet. Postoperative care occurs in a pediatric intensive care or step-down unit with airway monitoring, humidified oxygen, suctioning, and planned follow-up endoscopic evaluation for graft integration and airway patency.
Typical site of service: Operating room with pediatric anesthesia; postoperative care in pediatric intensive care unit or specialized pediatric step-down unit.
Service type: Major reconstructive pediatric airway surgery (open laryngoplasty via tracheotomy access) performed by pediatric otolaryngology specializing in airway reconstruction.
Coding Specifications
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