Otolaryngology Coding Alert

Question: Can I bill 31541 bilaterally to represent a bilateral laryngoscopy with operating microscope and stripping of vocal cords on both sides of the throat?California SubscriberAnswer: No. You should not append modifier 50 (Bilateral procedure) to 31541 (Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottitis; with operating microscope or telescope).The National Physician Fee Schedule Relative Value File assigns 31541 a bilateral surgery indicator of "0," meaning the 150 percent payment adjustment for bilateral procedures does not apply. "The bilateral adjustment is inappropriate for codes in this category (a) because of physiology or anatomy, or (b) because the code description specifically states that it is a unilateral procedure and there is an existing code for the bilateral procedure," according to the file.Instead: You should report 31541 for stripping of vocal cords, plural. Bill 31541 once, regardless of the number of vocal cords stripped or of [...]