Pulmonology Coding Alert

Question: The provider did a laryngoscopy along with removal of a foreign body. Please advise which code we should use. There are so many different foreign body removal codes that are applicable during a laryngoscopy. Is it possible to assess this just by seeing the patient documentation?

Michigan Subscriber

Answer: Yes, you do have four codes to choose from to report a foreign body removal during a laryngoscopy, such as:

• 31511 (Laryngoscopy, indirect; with removal of foreign body)
• 31530 (Laryngoscopy, direct, operative, with foreign body removal)
• 31531 (Laryngoscopy, direct, operative, with foreign body removal; with operating microscope or telescope)
• 31577 (Laryngoscopy, flexible fiberoptic; with removal of foreign body).

In order to report the right procedure, you’ll need to look through patient documentation, for some clues to point you in the right direction. If you see words like “mirror” or “indirect” being used, you are more likely to be seeing a simple procedure where the clinician uses a mirror as a guide and no scope was used during the procedure. In such a case, you report 31511.

If instead you see your clinician introducing a scope with fiberoptic cables through the nose to view the structures not normally viewable through the direct or indirect methods, or are seeing words like “fiberoptic,” “manipulated the scope,” or “nasopharyngeal fiberoptic laryngoscopy” in the patient documentation, your clinician has used a flexible fiberoptic scope and you should report the FBR with 31577.

If your provider performed the procedure with a flexible or rigid scope you may report 31530. If documentation identifies that your clinician used an operating microscope or a telescope for the procedure, you report 31531.