READER QUESTIONS: Opt for 31530 for FBR With Blade

Question: The physician removed a foreign body with a laryngoscope blade and Magill forceps, which a colleague told me to bill with 31575 (Laryn-goscopy, flexible fiberoptic; diagnostic). My concern is that this code usually pertains to a bronchoscope. Should I report 31575 anyway, even though the apparatuses were different from what the code stipulates?


Tennessee Subscriber

Answer: This is a tough situation, but your best bet is to report the foreign-body removal with 31530 (Laryngoscopy, direct, operative, with foreign-body removal) and append modifier 73 (Discontinued outpatient procedure prior to anesthesia administration) or 74 (Discontinued outpatient procedure after anesthesia administration).

Code 31575 does describe a laryngoscopy procedure--but one using a flexible fiberoptic laryngoscope. In the case you describe, the physician used a traditional metal (that is, inflexible) laryngoscope, so the 31575-31578 range does not apply.

Code 31530 reflects the equipment the physician used, but doctors generally perform this procedure in the operating room because it requires sedation to overcome the patient’s gag reflex. Your procedure doesn’t meet this criterion, so you should add a modifier. Be prepared: While this approach is your best chance for payment, payers may still reject your claim.