Otolaryngology Coding Alert

Question: The surgeon documented that he performed direct laryngoscopy with microlaryngoscopy. Preoperative diagnosis was hoarseness and post-op diagnosis was vocal fold nodules. The physician did not do a biopsy but told me to submit code 31536. I don’t think this is right, but don’t see a more appropriate code. What’s correct?

Oregon Subscriber

Answer: You’re correct in thinking that 31536 (Laryngoscopy, direct, operative, with biopsy; with operating microscope or telescope) isn’t the best code since the physician did not perform a biopsy. Instead, you should submit 31526 (Laryngoscopy direct, with or without tracheoscopy; diagnostic, with operating microscope or telescope).