# Microlaryngoscopy with Laser



## slund777@hotmail.com

Any help with this- Doctor did a Microlaryngoscopy with laser excision of subglottic Stenosis. He wants to use 31541 I say he needs to an unlisted code. Any help would be apprciated.


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## cpc2007

Hi 

I work with a few physicians performing a microlaryngoscopy with excision of stenosis, and I am coding an unlisted 31599. I've had this same conversation with physicians that felt the work of excising stenosis with the microlaryngoscopy was similar to that of excising a tumor, and should be reported with CPT 31541. In my experience, though, a claim denial typically arises when you try to pair the diagnosis supported (the subglottic stenosis) with the CPT 31541.  This code is meant for tumor excision or vocal cord stripping so even if you come at it from the perspective of the procedure work being similar, the diagnosis of stenosis will typically cause a medical necessity denial.  This is a tip I've shared with my physicians that has helped them understand why an unlisted code would be more appropriate. 

Finally, here's a Q&A from Karen Zupko who is a great consultant in surgical specialties like ENT, neurosurgery, and orthopedics: https://www.karenzupko.com/msl-with-lysis-of-stenosis-and-steroid-injection/. She also advocates using an unlisted 31599 and provides a good explanation of why she gives that recommendation. I thought I would share this additional resource in case it helps in your conversation with your provider. 

Have a good night
Kim
www.codingmastery.com


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## slund777@hotmail.com

*Thank You*

Thank You very much for your response hopefully it will help. fingers crossed  LOL We can dream. I did tell him we can use that for the comparison code.


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## cpc2007

LOL - I hear you .  You're welcome!

Kim


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