Summary & Overview
CPT 31587: Laryngoplasty (Cricoid Split) for Subglottic Airway Enlargement
CPT code 31587 represents a laryngoplasty procedure commonly known as a cricoid split, a surgical transection of the cricoid cartilage performed to enlarge the subglottic airway without graft placement. This operation is clinically important for managing congenital and acquired subglottic stenosis, conditions that can cause critical airway narrowing in pediatric and adult patients and often require specialized surgical and perioperative care. Nationally, the code matters because it captures a high-acuity, procedure-driven intervention that intersects surgical billing, inpatient and outpatient site-of-service determinations, and payer coverage policies for complex airway reconstruction.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical description, typical sites of service, and an outline of what to expect when billing or reviewing claims for this procedure. The publication summarizes common modifiers reported with the code, notes where data are available or missing, and situates CPT code 31587 within the broader context of otolaryngology surgical services and airway management. It is intended for clinicians, coding professionals, and policy analysts seeking a clear reference on the code’s clinical purpose, billing context, and payer landscape at the national level.
Billing Code Overview
CPT code 31587 describes a laryngoplasty (cricoid split) procedure in which the provider transects or divides the cricoid cartilage to enlarge the subglottic airway without placing a graft. This surgical repair addresses congenital or acquired subglottic stenosis, a narrowing of the airway below the vocal cords that can result from developmental anomalies, trauma, or infection.
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Service type: Surgical airway reconstruction (laryngoplasty/cricoid split)
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Typical site of service: Operating room or surgical suite, often within an otolaryngology (ENT) or pediatric surgery setting; inpatient or outpatient surgical centers depending on patient age, comorbidity, and airway management requirements.
Clinical & Coding Specifications
Clinical Context
A typical patient is a pediatric or adult patient presenting with symptomatic subglottic stenosis (congenital or acquired) causing stridor, respiratory distress, or exercise intolerance. The patient undergoes preoperative evaluation including airway endoscopy with direct laryngoscopy and bronchoscopy, cross-sectional imaging as indicated, and anesthetic assessment. In the operating room under general anesthesia, the otolaryngologist performs a laryngoplasty in the form of a cricoid split (31587) by transecting the cricoid cartilage to enlarge the subglottic airway; a graft is not placed as part of this code. Intraoperative steps include direct visualization of the subglottis, controlled division of the cricoid cartilage, airway stabilization, and assessment of airway caliber. Postoperative workflow includes extubation planning or temporary tracheostomy if indicated, postoperative airway monitoring in a recovery or pediatric ICU setting, analgesia, humidification, and follow-up endoscopic assessment to evaluate healing and airway patency. Typical sites of service are the operating room in an acute care hospital or ambulatory surgical center for stable patients, with postoperative observation in PACU or inpatient units when indicated. Common clinical indications include congenital subglottic stenosis, post-intubation stenosis, or acquired narrowing after trauma or infection.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |