For physical therapy professionals and practice owners, understanding medical billing codes is essential to ensuring accurate documentation, seamless reimbursement, and optimized revenue cycles. Among the many CPT codes used in healthcare billing, CPT code 31575 is one that physical therapy practices may encounter when dealing with speech-related therapy and diagnostic evaluations.
This guide will provide an in-depth look at CPT code 31575, including its definition, appropriate use, modifiers, Medicare reimbursement guidelines, and best practices for making the process more streamlined in a physical therapy setting.
CPT code 31575 refers to a diagnostic flexible fiberoptic laryngoscopy. This procedure is performed to examine the larynx (voice box) and assess abnormalities such as vocal cord nodules, polyps, airway obstruction, or issues affecting speech and swallowing.
The official CPT code 31575 description is:
Laryngoscopy, flexible fiberoptic; diagnostic.
This means the procedure involves inserting a thin, flexible tube with a light and camera through the nose or mouth to examine the larynx and surrounding structures. This minimally invasive procedure is critical for identifying conditions affecting voice and breathing.
While physical therapists do not perform laryngoscopies, they often work with speech-language pathologists (SLPs) and other healthcare providers who do. If your practice includes speech therapy services, it’s important to know when CPT code 31575 applies:
Since speech therapy is commonly integrated with physical therapy for neurorehabilitation or post-stroke recovery, understanding when and how to document CPT code 31575 can help practices ensure correct billing and compliance.
Modifiers are two-digit codes added to CPT codes to provide additional information about a procedure. When billing for CPT code 31575, the following modifiers may apply:
Physical therapy professionals working alongside SLPs or ENTs should ensure that billing teams are aware of these modifiers to prevent claims denials or underpayment.
Understanding Medicare reimbursement is crucial for maximizing revenue. CPT code 31575 is covered under the Medicare Physician Fee Schedule (MPFS), meaning that reimbursement is possible if certain conditions are met:
Since Medicare guidelines vary by region, it’s always advisable to check with the local MAC to ensure compliance and proper payment.
One of the biggest challenges in billing CPT code 31575 is ensuring accurate documentation. Patient symptoms, medical history, and the necessity of the procedure must be clearly recorded. Using electronic medical records (EMRs) can help track referrals and ensure that the documentation aligns with payer requirements.
Another common issue is claim denials due to missing modifiers. It’s essential to apply the correct modifier when needed and verify insurance payer policies to prevent claim rejections. If a modifier is omitted or incorrectly applied, insurers may bundle CPT code 31575 with other services, leading to lower reimbursements.
Reimbursement delays are another frequent problem. Staying updated on Medicare fee schedules and private insurance policies can help avoid disruptions in cash flow. Additionally, utilizing revenue cycle management (RCM) tools ensures that claims are monitored, follow-ups are conducted, and payments are processed efficiently.
Physical therapy professionals and practice owners can simplify CPT code 31575 billing with PtEverywhere, an advanced physical therapy software designed for modern clinics. Here’s how PtEverywhere makes the process easier:
With PtEverywhere, practice owners can minimize claim rejections, streamline documentation, and optimize revenue cycles, ensuring smooth and efficient billing for CPT code 31575.
For physical therapy professionals incorporating speech therapy services, understanding CPT code 31575 is essential for proper billing, reimbursement, and documentation.
By staying up to date on coding requirements, Medicare policies, and modifier use, practices can avoid denials and maximize revenue.