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The procedure described by CPT® Code 31560 is known as direct laryngoscopy with arytenoidectomy. This surgical intervention involves the excision or laser vaporization of the arytenoid cartilage, which is a critical component of the larynx, responsible for voice production and airway management. Arytenoidectomy is primarily indicated for patients suffering from bilateral vocal cord paralysis, a condition that can severely compromise the airway and hinder normal breathing. The use of a direct laryngoscope, which can be either a rigid angled scope or a flexible scope, allows the physician to visualize the laryngeal structures directly. The rigid scope is typically preferred for surgical procedures and is inserted through the mouth while the patient is under general anesthesia. During the procedure, the physician examines the oral cavity, oropharynx, hypopharynx, larynx, and trachea to ensure comprehensive assessment and treatment. To facilitate the surgery, a suspension device is utilized to maintain adequate exposure of the glottis, allowing for precise intervention. The mucosal layer covering the arytenoids and corniculate cartilage is vaporized using a laser, which helps to expose the arytenoids for the subsequent excision. The procedure may also involve the use of an operating microscope or telescope to enhance visualization and ensure meticulous vaporization of the tissues. It is important to note that CPT® Code 31560 is specifically used when the procedure is performed without the assistance of an operating microscope or telescope, while CPT® Code 31561 is designated for cases where such instruments are employed.
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Direct laryngoscopy with arytenoidectomy is indicated for patients experiencing the following conditions:
The procedure of direct laryngoscopy with arytenoidectomy involves several critical steps to ensure successful execution and patient safety:
After the completion of the direct laryngoscopy with arytenoidectomy, patients are typically monitored in a recovery area until the effects of anesthesia wear off. Post-procedure care may include pain management, monitoring for any signs of complications such as bleeding or infection, and ensuring that the airway remains patent. Patients may also receive instructions regarding voice rest and follow-up appointments to assess recovery and vocal function. It is essential for healthcare providers to provide clear guidance on post-operative care to facilitate optimal healing and recovery.
| Short Descr | LARYNGOSCOP W/ARYTENOIDECTOM | Medium Descr | LARYNGOSCOPY DIRECT OPERATIVE W/ARYTENOIDECTOMY | Long Descr | Laryngoscopy, direct, operative, with arytenoidectomy; | 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). | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) |
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| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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