Otolaryngology Coding Alert

Question: Does CPT^® code 31575 require laterality modifiers?

Oklahoma Subscriber

Answer: In performing a flexible laryngoscopy, the provider is examining an anatomic site that does not have a laterality component. Since you cannot objectively define the left versus right side of the larynx, it does not make much practical sense to be able to bill using modifiers LT (Left Side) and RT (Right Side), or 50 (Bilateral Procedure). 

However, an easier way to determine whether the procedure you’re coding can be reported bilaterally is by looking up the respective code’s bilateral surgery indicator. You can look up a code’s bilateral surgery indicator using the Medicare Physician Fee Schedule (MPFS) look up tool under the BILT SURG column.

You’ll find that 31575 (Laryngoscopy, flexible; diagnostic) has a bilateral surgery indicator of “0,” meaning that the concept of “bilateral” does not apply. The concept of “bilateral” may not apply for numerous reasons, but in this case, it’s based on an anatomic discrepancy.