Summary & Overview
CPT 31513: Laryngeal Examination with Vocal Cord Injection
CPT code 31513 covers laryngeal visualization with laryngeal mirror and injection of medication into a vocal cord for treatment or diagnosis of vocal cord paralysis, laryngitis, and related disorders. This code captures a combined diagnostic and therapeutic encounter commonly performed by otolaryngologists and voice specialists. Nationally, the code matters because it represents a procedure that bridges office-based diagnostic assessment and targeted treatment of vocal fold pathology, impacting access to minimally invasive care and reimbursement pathways for ENT services.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for the procedure, typical sites of service, common billing considerations, and payer coverage patterns. The analysis discusses benchmarks for utilization and allowed payment ranges where available, relevant coding practice considerations, and implications for outpatient ENT care delivery. The content is intended to inform billing staff, practice managers, and policy analysts about the clinical and administrative aspects of CPT code 31513, highlighting how this procedure is positioned within outpatient otolaryngology services.
Data not available in the input: specific ICD-10 pairings, modifier usage by payer, and payer-specific reimbursement rates.
Billing Code Overview
CPT code 31513 describes a clinician performing laryngeal examination using a laryngeal mirror to visualize the larynx (voice box) and administering an injection of medication directly into a vocal cord. The procedure is used to evaluate and treat conditions such as vocal cord paralysis and inflammatory or functional disorders of the vocal folds.
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Service type: Diagnostic laryngeal examination with therapeutic vocal cord injection
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Typical site of service: Office or outpatient otolaryngology (ENT) clinic; may also be performed in ambulatory surgical centers depending on clinical setting and patient needs.
Clinical & Coding Specifications
Clinical Context
A patient in their 50s presents to an otolaryngology clinic with unilateral breathy hoarseness and intermittent aspiration after a recent thyroid surgery. On history and flexible laryngoscopy, the right vocal fold demonstrates decreased mobility consistent with vocal cord paresis. The otolaryngologist schedules an in‑office diagnostic laryngeal mirror examination followed by a targeted injection laryngoplasty using a temporary injectable (e.g., carboxymethylcellulose or hyaluronic acid) into the paralyzed vocal fold to medialize the cord and improve glottic closure. The clinical workflow includes preprocedure consent and topical anesthesia, sterile preparation, visualization of the larynx with a laryngeal mirror, precise needle placement into the vocalis muscle under direct visualization, incremental injection of the implant material, immediate voice assessment in clinic, and short observation for airway compromise or bleeding before discharge. Documentation includes indication(s), informed consent, anesthesia type, materials injected (type and volume), procedural steps, immediate voice/airway response, and any complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting the physician’s professional work separate from technical services billed by another entity (rare for this in‑office procedure). |