General Surgery Coding Alert

Reader Questions:

Check Medical Necessity Before Coding 31575

Question: A surgeon does a thyroid lobectomy (60220) and following the procedure, the anesthesiologist extubates the patient and then the surgeon does a diagnostic laryngoscopy (31575) to  examine the vocal cords. Is the scope billable? Pennsylvania Subscriber

Answer: The scope is separately billable if it was medically necessary. In other words, if the patient was having hoarseness or swallowing difficulties or some other problem that would necessitate a laryngoscopy, you can report 31575 (Laryngoscopy, flexible fiberoptic; diagnostic).

Caveat: If the physician was just checking to be sure there was no damage from the thyroidectomy (60220, Total thyroid lobectomy, unilateral; with or without isthmusectomy), you should not separately code the laryngoscopy.

Reader Questions and You Be the Coder were prepared with the assistance of Marcella Bucknam, CPC, CCS-P, CPC-H, CCS, CPC-P, COBGC, CCC, manager of compliance education for the University of Washington Physicians Compliance Program.

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