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The procedure described by CPT® Code 31529 refers to a direct laryngoscopy, which is a medical procedure that allows a physician to visualize the larynx and surrounding structures using a specialized instrument known as a laryngoscope. This procedure can be performed with or without the addition of tracheoscopy, which involves examining the trachea. The laryngoscope can be either rigid or flexible; the choice of scope depends on the specific clinical situation and the area being examined. A flexible laryngoscope is typically inserted through the nostril, while a rigid laryngoscope is inserted through the mouth. During the procedure, the physician examines various anatomical regions, including the nasopharynx, oral cavity, oropharynx, hypopharynx, and larynx, for any signs of abnormalities or injuries. If necessary, the laryngoscope may be advanced into the trachea for further examination. A critical aspect of this procedure is the identification of any stenosis, or narrowing, of the airway. The physician assesses the location, length, and width of the stricture, as well as any areas of malacia (softening of tissue) or scarring, such as granulation tissue. Following this assessment, a dilation laryngoscope or tracheoscope is utilized to treat the stenosis. The conical tip of the dilation instrument is carefully advanced through the narrowed area and is typically left in place for a duration of 5 to 10 minutes to facilitate dilation. It is important to note that CPT® Code 31529 is specifically designated for subsequent dilation procedures, while CPT® Code 31528 is used for the initial dilation procedure.
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The procedure described by CPT® Code 31529 is indicated for patients who present with conditions that may cause airway obstruction or require direct visualization of the larynx and trachea. The following are specific indications for performing this procedure:
The procedure involves several key steps that ensure thorough examination and treatment of the airway. The following outlines the procedural steps:
After the completion of the procedure, the patient is monitored for any immediate complications or adverse reactions. Post-procedure care may include instructions for managing discomfort, monitoring for signs of airway obstruction, and follow-up appointments to assess the effectiveness of the dilation. The physician may also provide guidance on any necessary lifestyle modifications or further treatments based on the findings during the procedure. It is essential for the patient to report any unusual symptoms, such as difficulty breathing or persistent pain, to their healthcare provider promptly.
| Short Descr | LARYNGOSCOPY AND DILATION | Medium Descr | LARYNGOSCOPY W/WO TRACHEOSCOPY DILATION SUBSQ | Long Descr | Laryngoscopy direct, with or without tracheoscopy; with dilation, subsequent | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 3 - Special payment adjustment rules for multiple endoscopic procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Endoscopic Base Code | 31525 Laryngoscopy direct, with or without tracheoscopy; diagnostic, except newborn | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P8H - Endoscopy - laryngoscopy | MUE | 1 | CCS Clinical Classification | 42 - Other OR therapeutic procedures on respiratory system |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | GC | This service has been performed in part by a resident under the direction of a teaching physician | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | CR | Catastrophe/disaster related | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2002-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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