# Vocal cords right/left - use of modifier bilateral



## ALHW

Vocal cords right/left - use of modifier bilateral
Hello
Can you help me to understand why when a direct laryngoscopy was performed and polyps removed from left and right vocal cords. Why the modifier 50 is not used on CPT code 31540 to indicate bilateral? This is the same case for 31541 ( performed on each vocal cord).

Thank you,  this is my first question in this forum.
Regards
Alice


----------



## nsteinhauser

Welcome to the coding forum.  To find out if a cpt code accepts a 'bilateral' -50, (or a -RT or -LT if it is only on one side,) look on the National Physician Fee Schedule.  Under 31540 there is a "0" in the "BILAT SURG" column for this code, indicating it does not accept a laterality (or bilateral if both sides) modifier.  Hope this helps.


----------



## Candice_Fenildo

The larynx is considered a central structure, thus procedures are not typically reported as bilateral procedures. The verbiage in CPT 31540 and 31541 both state* "vocal cords*" thus these codes are reported one time only as the procedure includes both cords.

Good Luck


----------



## bungalowgirl

*bilat vocal cords?*

Candace,

I agree with you... just a comment on the logic behind defining the rules of some of these operative laryngoscopy codes... just last wk, one of my Drs billed a 31545: Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with local tissue flap(s)... THIS procedure, 
ALLOWS for 50 modifier... I'm just wondering, why this procedure, but not the 31540?


----------



## Candice_Fenildo

BungalowGirl.  The only fail safe answer to that is in the CPT descriptor. 31540-31541 states vocal cords. (S) plural. and the CPT descriptor for 31545 states vocal cord.

As silly as it sounds, thats the reason.


----------

