2025 CPT code 31545
(Active) Effective Date: N/A Revision Date: N/A Surgery - Laryngoscopy Surgery Feed
Direct operative laryngoscopy using a microscope or telescope, involving submucosal removal of non-cancerous vocal cord lesions and reconstruction using a local tissue flap.
Modifiers 50 (bilateral procedure) and 22 (increased procedural services) may apply under specific circumstances.
Medical necessity is established by the presence of vocal cord lesions that impair vocal function or cause respiratory distress.The procedure is medically necessary to alleviate these symptoms and improve the patient's quality of life.
The otolaryngologist (ENT surgeon) is responsible for the entire procedure, including patient preparation, anesthesia administration (if applicable), laryngoscopy, lesion removal, tissue flap creation and placement, and wound closure.An anesthesiologist may also participate, particularly if general anesthesia is utilized.
In simple words: The doctor uses a special scope and possibly a microscope to look directly at your vocal cords.If there are any non-cancerous growths, they're carefully removed, and the area is repaired using nearby tissue.
This CPT code encompasses a direct operative laryngoscopy performed with the aid of an operating microscope or telescope.The procedure involves the precise submucosal removal of one or more benign (non-neoplastic) lesions located on the vocal cord(s). Following lesion excision, reconstruction is achieved using locally harvested tissue flaps. This approach aims to restore normal vocal cord structure and function, mitigating potential voice impairments or breathing difficulties stemming from the lesions.
Example 1: A 50-year-old male presents with hoarseness and vocal fatigue.Direct laryngoscopy reveals multiple small vocal cord polyps.Code 31545 is used to document the removal of the polyps and reconstruction with local flaps., A 62-year-old female has a history of vocal cord trauma.A vocal cord granuloma is detected during a direct laryngoscopy.Code 31545 is appropriate for the excision of the granuloma and subsequent local flap reconstruction., A 35-year-old singer experiences persistent voice changes after a viral infection.A direct laryngoscopy reveals a vocal cord cyst.Code 31545 accurately reflects the excision of the cyst and reconstruction using a local flap to ensure optimal vocal cord function.
Pre-operative evaluation notes, including patient history, physical examination findings, imaging studies (if any), and diagnosis.Operative report detailing the type of laryngoscopy, equipment used, lesions removed, tissue flap creation and placement, and closure technique.Post-operative notes documenting the patient's recovery and any complications.
** For bilateral procedures, the payment is the lower of the total actual charge or 150% of the fee schedule amount for a single code.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: This information is not available in the provided source.RVUs vary based on geographic location and other factors. Consult a relevant fee schedule for current values.
- Global Days: The global period for this procedure is not specified in the provided sources.The global period will depend on payer guidelines and the complexity of the procedure.
- Payment Status: Active
- Modifier TC rule: The technical component (TC) modifier may apply depending on the context of the billing scenario.
- Fee Schedule: Fee schedules vary over time and by payer.Consult historical fee schedules from relevant payers (Medicare, private insurers) for specific data.
- Specialties:Otolaryngology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Office