Wiki Multiple Larngoscopes

CROBINSON1988

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Hello,

The physician wants to code the following procedure as 31571 only. But to me it seems he is missing multiple procedures.
Here's the op:
A dedo laryngoscope was inserted and supraglottic jet ventillation was started. the base of the tongue pyriform sinuses, and post-cricoid space were examines and found to be normal. The laryngoscope was then suspended and the operating microscope was brougt into the field. Wet eyepatches were placed on the patient. The CO2 laser was used to make 4 radial incisions in the region of the stenosis. The 14 mm acclarent dilator was then inflated to 10atm pressure. The patient was then intubated by myself using a #5 ETT and ventilation was resumed. Kenalog was injected in the region of the stenosis and a biopsy was taken from the left stenotic region.

To me I see: 31571,31528 but I am unsure how to code for the use of the laser because a direct laryngoscope was used.
Any help would be great.
 
What I see. CPT 31571 (Laryngoscopy, direct, with injection into vocal cord(s), therapeutic; ) + 31536 (Laryngoscopy direct, with or without tracheoscopy; with dilation, initial) Mod 22 for Laser + CPT 31536 (Laryngoscopy, direct, operative, with biopsy;).

Some state to use CPT 31528 w/mod 22 or unlisted CPT 31599 when radial laser incisions are done with dilation after. Either way is fine, I'd go with CPT 31528.22.
 
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