CPT® Code 31520

1. Indications

The diagnostic laryngoscopy procedure, represented by CPT® Code 31520, is indicated for newborns who present with symptoms or conditions that necessitate direct visualization of the laryngeal structures. Common indications for this procedure may include:

• Respiratory Distress: Newborns exhibiting difficulty in breathing may require this procedure to assess for any obstructions or abnormalities in the airway.
• Stridor: The presence of stridor, a high-pitched wheezing sound, may indicate laryngeal or tracheal issues that need to be evaluated.
• Persistent Cough: A cough that does not resolve may warrant examination of the larynx and surrounding structures to identify potential causes.
• Abnormal Crying: Changes in the quality of a newborn's cry may suggest laryngeal abnormalities that require investigation.
• Congenital Anomalies: Newborns suspected of having congenital laryngeal or tracheal anomalies may be referred for this diagnostic procedure.

2. Procedure

The procedure for a diagnostic laryngoscopy using CPT® Code 31520 involves several key steps, which are outlined as follows:

• Step 1: Preparation of the Patient - The newborn is positioned appropriately, often in a supine position, to facilitate access to the airway. The physician ensures that the environment is sterile and that all necessary equipment is ready for use.
• Step 2: Anesthesia Administration - Depending on the clinical scenario, local anesthesia may be administered to minimize discomfort during the procedure. In some cases, sedation may be considered to ensure the newborn remains calm.
• Step 3: Insertion of the Laryngoscope - The physician selects either a rigid or flexible laryngoscope based on the clinical needs. The chosen scope is carefully inserted through the mouth or nostril, respectively, to access the larynx.
• Step 4: Visualization and Examination - Once the laryngoscope is in place, the physician visualizes the laryngeal structures, including the vocal cords and surrounding tissues. The examination focuses on identifying any abnormalities such as lesions, lacerations, or strictures.
• Step 5: Tracheal Examination (if applicable) - If necessary, the laryngoscope may be advanced into the trachea to assess for any additional abnormalities or obstructions within the airway.
• Step 6: Completion of the Procedure - After the examination is complete, the laryngoscope is carefully removed, and the newborn is monitored for any immediate post-procedure effects.

3. Post-Procedure

Following the diagnostic laryngoscopy, the newborn is typically monitored for any signs of complications, such as respiratory distress or bleeding. The physician may provide specific post-procedure care instructions, which could include observing the newborn for any changes in breathing patterns or signs of discomfort. Depending on the findings during the procedure, further evaluation or treatment may be recommended. It is essential to ensure that the newborn is stable before discharge and that caregivers are informed about any necessary follow-up appointments or additional assessments that may be required.