Otolaryngology Coding Alert

Answer: CPT® doesn’t include a code that is specific to the procedure in question. Your best option is to report an unlisted code such as 31599 (Unlisted procedure, larynx). Be sure to include documentation of the surgeon’s work so the payer will understand what he did. If the laryngoscopic procedure failed or could not be completed in full endoscopically and the doctor has to revert to an open excision of the mucocele the corresponding open procedure, 42808 (Excision or destruction of lesion of pharynx, any method) would be coded, not 31599.  

 

If the operative note demonstrates excessive work and difficulty because of both the attempted laryngoscopic removal which had to be converted to an open removal, add modifier 22 (Increased procedural services) and increase your fee. You’ll probably have to appeal payment of a 22 modified service as third party payers usually do not acknowledge 22 modified claims on initial submission. You’ll only be able to be paid the additional money via an appeal that points out the additional work and difficulty that was experienced during the service.