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The procedure described by CPT® Code 31561 is known as direct laryngoscopy with arytenoidectomy, which involves the surgical removal or vaporization of the arytenoid cartilage in the larynx. The arytenoids are crucial structures that play a significant role in voice production and airway management. Arytenoidectomy is typically performed to alleviate breathing difficulties, particularly in patients suffering from bilateral vocal cord paralysis, a condition where both vocal cords are unable to move properly, leading to airway obstruction. During this procedure, a direct laryngoscope is utilized, which is a specialized instrument that allows the physician to visualize the laryngeal structures directly through fiberoptic technology. There are two main types of direct laryngoscopes: rigid and flexible. The rigid angled scope is predominantly used in surgical settings and is inserted through the mouth while the patient is under general anesthesia. This allows for a thorough examination of the oral cavity, oropharynx, hypopharynx, larynx, and trachea. To perform the arytenoidectomy, the larynx is carefully exposed, often with the aid of a suspension device to ensure optimal visibility of the glottis. The procedure involves vaporizing the mucosa over the arytenoids and corniculate cartilage using a laser, which facilitates access to the arytenoid cartilage itself. The surgeon then vaporizes part or all of the arytenoid cartilage to improve the patient's airway. The use of an operating microscope or telescope during this procedure enhances visualization, allowing for more precise and meticulous vaporization of the tissues involved. It is important to note that CPT® Code 31560 should be used when the procedure is performed without the assistance of an operating microscope or telescope, while CPT® Code 31561 is specifically designated for cases where these advanced visualization tools are employed.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure of direct laryngoscopy with arytenoidectomy (CPT® Code 31561) is indicated for patients experiencing specific conditions that compromise their airway and vocal function. The primary indications include:
The procedure of direct laryngoscopy with arytenoidectomy involves several critical steps to ensure successful execution and patient safety. The steps are as follows:
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 the following considerations:
| Short Descr | LARYNSCOP REMVE CART + SCOP | Medium Descr | LARGSC ARYTENOIDECTOMY MICROSCOPE/TELESCOPE | Long Descr | Laryngoscopy, direct, operative, with arytenoidectomy; with operating microscope or telescope | 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 | 31526 Laryngoscopy direct, with or without tracheoscopy; diagnostic, with operating microscope or telescope | 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 |
| 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. | 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | 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) | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | RT | Right side (used to identify procedures performed on the right side of the body) | 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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| 2011-01-01 | Changed | Short description changed. |
| 2006-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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