Otolaryngology Coding Alert

Question: The surgeon performs a laryngoscopy with laser ablation of a papilloma. What code should I use to report the laser ablation portion of the surgery?

Arizona Subscriber

Answer: The laser ablation should not be reported with a separate CPT^® code from the laryngoscopy. The laser ablation is simply the technique the surgeon uses to remove the papilloma. While no laryngoscopy with laser ablation code exists, you’ll find that code 31540 (Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis) will work in this situation.

You should not be deterred by the use of the word “excision” within the code description. Excision, for all intents and purposes, can refer to a more traditional form of excision using a scalpel, or that of a laser ablation. Additionally, 31540 qualifies as the correct code since a papilloma is, by definition, a benign neoplasm, or tumor.

Coder’s note: If the provider documents the use of forceps to grip and pull the epithelium of the vocal cord or epiglottis, you may also report code 31450. This technique is also known as stripping.