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2025 CPT code 31591

Unilateral medialization laryngoplasty; restores larynx function by repositioning a displaced vocal cord.

Follow CPT guidelines for surgical procedures and appropriate documentation.

Modifiers 50 (bilateral procedure), 51 (multiple procedures), and others may be applicable depending on the specific circumstances of the procedure. Consult the CPT manual and payer guidelines.

Medialization laryngoplasty is medically necessary when conservative treatment fails to improve symptoms of unilateral vocal cord paralysis or related conditions causing glottic insufficiency, significantly impacting breathing, speaking, or swallowing.

The otolaryngologist (ENT surgeon) performs the procedure.Responsibilities include patient preparation and anesthesia, making incisions, creating a window in the larynx, implant placement, vocal cord assessment using a laryngoscope (potentially with patient vocalization), hemostasis, and wound closure.

IMPORTANT:For laryngoscopy with injection to medialize the vocal cord, report 31574.Other thyroplasty types (II, III, IV) exist for different laryngeal issues.

In simple words: This surgery fixes a problem with the voice box where one vocal cord doesn't move properly. The surgeon makes a small cut in the neck, moves the vocal cord to improve breathing, speaking, and swallowing, and inserts a small implant to keep it in place.

Medialization laryngoplasty (Type I thyroplasty) is a surgical procedure to restore the function of the larynx (voice box) by repositioning a displaced or paralyzed vocal cord.A small incision is made in the neck, and a window is created in the larynx to access the vocal cord. An implant or graft is inserted to move the affected vocal cord towards the midline, improving breathing, vocalization, and swallowing. A laryngoscope may be used to examine vocal cord position and make adjustments.The procedure addresses unilateral vocal cord paralysis or other conditions causing glottic insufficiency.

Example 1: A 55-year-old female presents with hoarseness and dysphagia following a surgical procedure on her neck.A laryngeal examination reveals unilateral vocal fold paralysis. Medialization laryngoplasty is performed to restore vocal cord function., A 70-year-old male with a history of vocal cord dysfunction due to a neurological disorder exhibits significant dyspnea. A medialization laryngoplasty is used to improve airway patency and reduce breathing difficulties., A 30-year-old transgender individual seeks voice feminization.Medialization laryngoplasty is part of a multi-step procedure to adjust vocal pitch and quality.

Pre-operative laryngeal examination, intra-operative images/videos, postoperative laryngoscopy findings and audio recordings of vocal quality, pathology reports (if applicable).

** Implant extrusion is a potential complication.The choice between medialization laryngoplasty and injection laryngoplasty depends on factors such as patient preference, medical history, and anticipated longevity of the treatment.Pre-operative assessment must carefully consider the patient's overall health status.

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