Question Laryngeal cleft repair with injection

Manders21

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The doctor performed a laryngeal cleft repair with prolaryn plus. I originally was thinking cpt code 31571 or 31574. But those codes mention injection in the vocal cords and I can't find another code that is maybe closer. Does anyone have an idea if those codes are appropriate or if there is a better option? Here is the op report:

Procedure performed: Microtelescopic direct laryngoscopy, bronchoscopy, repair of laryngeal cleft with prolaryn plus

After consent was obtained the patient was taken to the OR and laid supine on the table. Anesthesia was inducted. Time-out procedure was performed. Laryngoracheal anesthesia was administered. Using a Parsons laryngoscope, the epiglottis was elevated, and the glottic structures were visualized. Findings as above. Using a zero degree Hopkins rod, the subglottis was brought into view. The rod was carefully removed. No stenosis was identified. The rod was then reinserted advanced to the carina, which was sharp. Bilateral mainstem bronchi were free of any masses or lesions. The laryngoscope was then susupended and the laryngeal cleft was repaired. The cleft was above the cords and was injected with 0.2cc of Prolaryn plus gel. The scope was then carefully removed.
 

fwnewbie

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The way I read this, a filler substance was used to provide closure to a laryngeal cleft. Had nothing to do with vocal cords since the defect was stated "above the cords". Maybe you'll find something under the Injection category of codes.
 

wisibyusha

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I believe the procedure is therapeutic since the goal is to repair the cleft. According to the report it says direct laryngoscopy which crosses out the 31574 code which is under laryngoscopy, flexible. The procedure also included microtelescope which leads us to the CPT code 31571. And prolaryn plus was injected so we have to report it using HCPCS code C1878. Hope this makes sense.
 

Manders21

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I believe the procedure is therapeutic since the goal is to repair the cleft. According to the report it says direct laryngoscopy which crosses out the 31574 code which is under laryngoscopy, flexible. The procedure also included microtelescope which leads us to the CPT code 31571. And prolaryn plus was injected so we have to report it using HCPCS code C1878. Hope this makes sense.
Thank you!
 

b.cobuzzi

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This was not 31574. 31574 is a scope that goes through the nose and down the nasopharynx, down to the vocal cords. General anesthesia/sedation is NOT used for 31574. If the scope goes into the patient’s mouth while the patient is sedated or under general anesthesia, it is a direct laryngoscopy. This would be coded with unlisted 31599 - Unlisted procedure, larynx. You can equate it to 31574 for pricing in box 19. The direct diagnostic laryngoscopy and bronchoscope would be bundled with the functional laryngoscopic repair of the cleft with gel. (Some doctors call this an endoscopic laryngoplasty when it is performed on the vocal cords, using gel, centering the vocal cords)

Only the facility charges the “C” code. Surgeons cannot bill C HCPCS codes.
 

GAcoder

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This was not 31574. 31574 is a scope that goes through the nose and down the nasopharynx, down to the vocal cords. General anesthesia/sedation is NOT used for 31574. If the scope goes into the patient’s mouth while the patient is sedated or under general anesthesia, it is a direct laryngoscopy. This would be coded with unlisted 31599 - Unlisted procedure, larynx. You can equate it to 31574 for pricing in box 19. The direct diagnostic laryngoscopy and bronchoscope would be bundled with the functional laryngoscopic repair of the cleft with gel. (Some doctors call this an endoscopic laryngoplasty when it is performed on the vocal cords, using gel, centering the vocal cords)

Only the facility charges the “C” code. Surgeons cannot bill C HCPCS codes.

Hi Barbara,
Would this not be 31571?
 

b.cobuzzi

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GAcoder, 31571 is for an injection into the vocal cords. This injected gel into the larnyx which moves the vocal cords to center. Some surgeons call this an endoscopic injection laryngectomy. It is a lot more than 31571, which is usually an injection of a steroid into the vocal cords. This laryngoscopy with injection of gel is more complex than 31571.
 

GAcoder

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GAcoder, 31571 is for an injection into the vocal cords. This injected gel into the larnyx which moves the vocal cords to center. Some surgeons call this an endoscopic injection laryngectomy. It is a lot more than 31571, which is usually an injection of a steroid into the vocal cords. This laryngoscopy with injection of gel is more complex than 31571.
Thank you for that explanation.
 
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