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This procedure, known as laryngoscopy with injection into the vocal cord(s), is a therapeutic intervention primarily aimed at addressing vocal cord atrophy or paralysis. It is commonly referred to as injection medialization laryngoplasty. During this procedure, a direct laryngoscope is utilized, which allows the physician to visualize the anatomical structures of the larynx and surrounding areas using fiberoptic technology. The direct laryngoscope can be either a rigid angled scope or a flexible scope, enabling comprehensive examination of the oral cavity, oropharynx, hypopharynx, larynx, and trachea. The visualization of the vocal cords is critical, as it allows for precise placement of the injection. The laryngoscope is typically suspended to maintain a stable view of the vocal cords, and additional tools such as an operating microscope or telescope may be employed to enhance the examination and facilitate the injection process. The injection itself is performed lateral to the thyroarytenoid muscle within the paraglottic space, utilizing either a resorbable material for temporary effects or an implant material for more permanent results. This injection serves to bulk up the vocal cord, repositioning it closer to a normal anatomical position, which can significantly improve vocal function. Following the injection, the physician assesses the patient's response to the treatment to determine if the desired outcome has been achieved or if further injections are necessary. The procedure can be conducted unilaterally or bilaterally, depending on the patient's specific condition and needs.
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The procedure is indicated for the following conditions:
The procedure involves several key steps to ensure effective treatment of the vocal cords:
Post-procedure care involves monitoring the patient for any immediate complications and providing guidance on voice rest and hydration. Patients may be advised to avoid strenuous vocal activities for a specified period to allow for optimal healing. Follow-up appointments are typically scheduled to assess the effectiveness of the injection and to determine if further treatment is necessary. The physician will evaluate the patient's vocal function and overall recovery during these follow-up visits.
| Short Descr | LARYNGOSCOPE W/VC INJ | Medium Descr | LARYNGOSCOPE INJECTION VOCAL CORD THERAPEUTIC | Long Descr | Laryngoscopy, direct, with injection into vocal cord(s), therapeutic; | 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) | 1 - Statutory 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 |
| GC | This service has been performed in part by a resident under the direction of a teaching physician | 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). | 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.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | LT | Left side (used to identify procedures performed on the left side of the body) | P3 | A patient with severe systemic disease | QZ | Crna service: without medical direction by a physician | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service | 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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| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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