2025 CPT code 31541
(Active) Effective Date: N/A Revision Date: N/A Surgery - Endoscopy Procedures on the Larynx Surgery Feed
Direct laryngoscopy, operative, with excision of tumor and/or stripping of vocal cords or epiglottis; using operating microscope or telescope.
Modifiers may apply depending on the circumstances of the service. Consult the CPT manual and payer-specific guidelines for applicable modifiers.
Medical necessity for 31541 is established by the presence of a benign or malignant lesion in the larynx that requires surgical removal to improve vocal function, breathing, or to address potentially life-threatening conditions.
The otolaryngologist (ENT surgeon) or another qualified physician performs the procedure.This includes pre-operative evaluation, obtaining informed consent, performing the surgical procedure under appropriate anesthesia, and providing post-operative care.
In simple words: The doctor uses a special scope and a magnifying instrument or a small camera to look inside your voice box. If there's a growth or abnormal tissue, they remove it using tiny surgical tools.
This CPT code encompasses a direct laryngoscopy procedure performed operatively, involving the excision of a tumor and/or the stripping (removal of the outer layer) of the vocal cords or epiglottis.The procedure utilizes an operating microscope and/or a telescope to achieve precise visualization and manipulation during the surgical intervention. The procedure involves direct visualization of the larynx and hypopharynx using a laryngoscope, followed by the removal of abnormal tissue using surgical instruments under microscopic or telescopic guidance.
Example 1: A patient presents with a vocal cord polyp detected during a routine laryngoscopy.The surgeon performs a microlaryngoscopy with excision of the polyp using a CO2 laser under the guidance of an operating microscope., A patient with a history of vocal cord dysplasia undergoes a microlaryngoscopy.The surgeon excises a suspicious lesion and performs stripping of the adjacent vocal cord epithelium to ensure complete removal of abnormal tissue., A patient presents with a laryngeal carcinoma. The surgeon performs microlaryngoscopy with excision of the tumor using a surgical microscope and specialized forceps. A small portion of healthy tissue surrounding the tumor is also removed to ensure clear margins and reduce the risk of recurrence.
* Detailed history and physical examination focusing on the patient's voice symptoms and laryngeal findings.* Preoperative imaging studies (e.g., laryngeal endoscopy, CT scan, MRI) to confirm the diagnosis and assess the extent of the lesion.* Operative report detailing the type of laryngoscopy performed, the technique used (excision, stripping, or both), the size and location of the lesion, and any complications encountered.* Pathology report if tissue was sent for analysis.* Postoperative progress notes documenting the patient's recovery and any complications.
** This procedure is typically performed under general anesthesia or conscious sedation. The choice of operative technique (excision vs. stripping) will depend on the type, size, and location of the lesion.Post-operative care includes monitoring for bleeding, infection, and assessing vocal cord function.
- Revenue Code: P8H (Endoscopy - Laryngoscopy)
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier may or may not be applicable; this depends on whether the procedure was performed independently by a qualified surgeon, or in conjunction with other services.Always consult with payer-specific coding guidelines to ensure correct application.
- Specialties:Otolaryngology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Office