CPT 31584 Laryngoplasty Reimbursement & Policy | OpenPayer

Summary & Overview

CPT 31584: Laryngoplasty for Laryngeal Fracture

CPT code 31584 represents surgical laryngoplasty to repair or alter the larynx specifically for a laryngeal fracture; the operation may include tracheostomy for airway control. This code captures a high-acuity, trauma-related head and neck surgical procedure with implications for airway management, voice preservation, and airway protection. Nationally, accurate coding of 31584 affects trauma registry data, hospital case mix, and billed surgical complexity for otolaryngology and trauma services. Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise clinical and billing context for 31584, including the typical service setting and what this procedure signifies clinically. The publication outlines common billing considerations, relevant clinical scenarios prompting use of the code, and the types of benchmarks and policy content to expect (coverage patterns, reimbursement benchmarks, and coding guidance highlights). Data not available in the input is noted where applicable. The focus is national: the content supports clinicians, coding professionals, and policy analysts who need a clear, operational summary of CPT code 31584 and its role in trauma and otolaryngology surgical care.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare31584CPTlaryngoplastylaryngeal fracturetracheostomyotolaryngologytrauma surgeryoperating room

Billing Code Overview

CPT code 31584 describes laryngoplasty for repair or alteration of the larynx performed to treat a fracture of the larynx. The procedure may include surgical repair of laryngeal structures and, when necessary, a tracheostomy to secure the airway and allow the patient to breathe during the operation. Indications include laryngeal injury from penetrating or blunt trauma such as motor vehicle accidents, sports injuries, or assaults.

Service Type: Surgical — Head & Neck / Otolaryngology

Typical Site of Service: Hospital operating room or other inpatient surgical setting where airway management and potential tracheostomy can be performed safely.

Clinical & Coding Specifications

Clinical Context

A 42-year-old male is brought to the emergency department after a high-speed motor vehicle collision with direct anterior neck trauma. He complains of severe neck pain, hoarseness, dysphonia, subcutaneous emphysema, and respiratory distress with fluctuating oxygen saturation. Flexible laryngoscopy in the ED demonstrates displaced laryngeal cartilage and mucosal disruption consistent with a laryngeal fracture. The trauma team coordinates airway management; because definitive airway control and surgical exposure are required, the otolaryngology surgeon performs open laryngoplasty for repair of fractured thyroid cartilage and endolaryngeal mucosal reconstruction. A temporary tracheostomy is performed during the operation to secure the airway and allow controlled ventilation while the larynx is repaired. The patient proceeds to postoperative monitoring in the intensive care unit with plans for ventilator weaning and tracheostomy decannulation per recovery.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work or time is substantially greater than typical for `31584` due to extensive reconstruction.
`23`

CPT 31587: Laryngoplasty (Cricoid Split) for Subglottic Airway Enlargement

CPT-31580-LARYNGOPLASTY-LARYNGEAL-WEB-REMOVAL-KEEL-PLACEMENT

CPT 31580: Laryngoplasty for Laryngeal Web Removal with Keel Placement

CPT-31590-LARYNGEAL-NEUROMUSCULAR-FLAP-REINNERVATION

CPT 31590: Laryngeal Neuromuscular Flap Reinnervation

CPT-31591-VOCAL-CORD-MEDIALIZATION-LARYNGEAL-RESTORATION

CPT 31591: Medialization of Displaced or Paralyzed Vocal Cord

CPT-31592-TRACHEAL-RESECTION-PRIMARY-ANASTOMOSIS-SUBGLOTTIC-STENOSIS

CPT 31592: Tracheal Resection with Primary Anastomosis for Subglottic Stenosis

Taxonomy Code	Specialty	Notes
207W00000X	Otolaryngology (ENT)	Primary specialty performing laryngoplasty and airway reconstruction.
2080P0208X	Otolaryngology - Pediatric	Pediatric airway surgeons for pediatric laryngeal trauma or congenital airway disease.
2084P0800X	General Surgery	Trauma/general surgeons involved in initial airway and neck trauma management.
163W00000X	Critical Care Medicine	Intensivists who manage perioperative ventilatory support and tracheostomy care.
207L00000X	Oral and Maxillofacial Surgery	May be involved for complex laryngofacial trauma affecting mandible or adjacent structures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S12.89XA`	Fracture of other specified parts of neck, initial encounter	Cervical and laryngeal skeletal trauma may accompany laryngeal fractures requiring repair.
`S12.2XXA`	Fracture of larynx, initial encounter	Direct code for laryngeal fracture indicating the primary reason for `31584`.
`S02.2XXA`	Fracture of mandible, initial encounter	Facial fractures frequently occur with laryngeal trauma and influence airway management and operative planning.
`S16.1XXA`	Injury of larynx and trachea, initial encounter	Broad code for laryngeal and tracheal injuries often associated with need for laryngoplasty and tracheostomy.
`T14.90XA`	Injury of unspecified body region, initial encounter	Used when specific injury codes are not yet established on initial trauma evaluation; may be updated later.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`31600`	Tracheostomy, planned (separate procedure); superficial cervical tracheostomy.	Performed when a tracheostomy is required for airway control prior to or during laryngeal repair; sometimes billed if separate from `31584`.
`31231`	Nasopharyngoscopy, flexible; diagnostic, with endoscope with video documentation.	Diagnostic flexible laryngoscopy used preoperatively to evaluate laryngeal injury and guide operative planning.
`31505`	Laryngoscopy, direct; diagnostic with operating microscope, when performed for assessment or biopsy.	Direct laryngoscopy may be performed intraoperatively to visualize endolaryngeal mucosa and injuries during repair.
`31587`	Laryngoplasty, including repair of laryngeal framework, other than for fracture (adjacent reconstructive procedures).	Related reconstructive laryngoplasty codes that may be used for additional or alternative framework repairs.
`21550`	Open treatment of mandibular fracture, stabilization (example facial fracture repair).	Facial or mandible fracture repairs that commonly occur in blunt trauma alongside laryngeal fractures and may be performed in the same operative setting.

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