2025 CPT code 31574
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Respiratory System Surgery Feed
This code pertains to a flexible laryngoscopy procedure where injection(s) are administered for vocal cord augmentation. This procedure is typically performed unilaterally (on one side).
Modifiers may be applicable in certain situations.Modifier 22 (Increased Procedural Services) may be used if the procedure is significantly more complex than usual. Modifier 52 (Reduced Services) may be used if the procedure is discontinued or not completed as planned. Modifier 59 (Distinct Procedural Service) may be used if the injection is performed in conjunction with another procedure on the larynx and it is important to distinguish the two services.
Medical necessity for this procedure must be established by documenting the underlying diagnosis affecting the vocal cords (paralysis, atrophy, scarring, etc.) and the resulting functional impairment (hoarseness, breathiness, difficulty speaking, etc.).The documentation should demonstrate how the procedure is expected to improve the patient's voice and quality of life.
The physician is responsible for preparing the patient, administering anesthesia (if necessary), performing the laryngoscopy, injecting the filler material, and ensuring proper visualization and documentation of the procedure.They also must select the appropriate filler material based on the individual patient's needs and condition.
In simple words: The doctor uses a thin, flexible tube with a camera and light (a laryngoscope) to look at your voice box. Then, they inject a filler material into one side of your vocal cords to make them bigger. This can help if your vocal cords are paralyzed, weak, or scarred.
The procedure involves inserting a flexible laryngoscope, usually through the nose, to visualize the larynx and hypopharynx. After confirming the vocal fold positioning, a filler material is injected into one side of the vocal folds. The injection can be performed percutaneously (through the skin) or transorally (through the mouth). Various filler substances may be used, including calcium hydroxylapatite, hyaluronic acid, collagen, fat, or other approved materials.This procedure is commonly used to address vocal fold paralysis, atrophy, or scarring. Following the injection, the larynx is re-examined, and the laryngoscope is withdrawn.
Example 1: A patient with unilateral vocal cord paralysis causing hoarseness undergoes flexible laryngoscopy with injection of calcium hydroxylapatite to improve vocal cord closure and voice quality., A patient with vocal cord atrophy due to aging experiences breathiness and weak voice. They undergo flexible laryngoscopy with injection of hyaluronic acid for vocal cord augmentation., A patient with vocal cord scarring from previous surgery or trauma has difficulty speaking.They have flexible laryngoscopy with injection of a biocompatible filler material to improve vocal cord function.
Documentation should include the type of laryngoscope used, the approach (percutaneous or transoral), the type and amount of filler injected, the location of the injection, the pre- and post-injection vocal cord assessment, and any complications encountered. Pre- and post-procedure voice recordings are also beneficial.
** If a diagnostic laryngoscopy (31575) is performed during the same encounter for a separate condition, it can be reported separately. The use of an operating microscope or telescope is included in this code and should not be reported separately.
- Revenue Code: P8H (ENDOSCOPY - LARYNGOSCOPY)
- Payment Status: Active
- Specialties:Otolaryngology
- Place of Service:Office, Ambulatory Surgical Center, Outpatient Hospital, Inpatient Hospital