Understand Approach, Repair to Choose the Correct Microlaryngeal Cordectomy Code
Question: What is the correct CPT® code for a microlaryngeal cordectomy? AAPC Forum Participant Answer: Coding for a microlaryngeal cordectomy, a procedure where a provider removes all or part of a patient’s vocal cord either to remove benign polyps or cysts or to treat glottic cancer, depends on two things: the approach the surgeon takes and whether the surgeon performs reconstruction on the vocal cords after the lesions have been removed. If the surgeon uses a laryngoscope and a microscope to see the larynx, you would use 31541 (Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis; with operating microscope or telescope). However, if the surgeon uses an open approach and makes an incision directly into the larynx, you’ll use 31300 (Laryngotomy (thyrotomy, laryngofissure), with removal of tumor or laryngocele, cordectomy). Neither of these codes describes any subsequent repair the surgeon may perform. If that occurs, and depending on whether the surgeon repairs the patient’s larynx with flaps or a graft, you’ll use either 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)) or 31546 (… reconstruction with graft(s) (includes obtaining autograft)). Bruce Pegg, BA, MA, CPC, CFPC, Managing Editor, AAPC
