Summary & Overview
CPT 31515: Direct Laryngoscopy with Aspiration of Laryngeal/Tracheal Material
CPT code 31515 represents direct laryngoscopy with aspiration of material from the larynx, sometimes including tracheoscopy to inspect the trachea. Nationally, this procedure is a focused airway diagnostic and therapeutic maneuver used in acute and perioperative care to clear secretions, blood, or aspirated material and to evaluate laryngeal and tracheal pathology. It matters because timely visualization and removal of obstructing material can affect airway patency, perioperative safety, and emergency airway management outcomes.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines clinical context for use of the code, typical sites of service (operating room, procedure suite, emergency department, inpatient), and common billing practice considerations. Readers will find national benchmarks where available, coding and billing guidance highlights, and relevant policy updates that influence coverage and payment for this procedure. The analysis also summarizes clinical indications, procedure components, and documentation points that underpin appropriate use of the code.
Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 31515 describes direct laryngoscopy with aspiration of mucus, blood, or other material from the larynx. The procedure uses a laryngoscope to visualize the larynx (voice box) and remove fluid or material; the clinician may also perform tracheoscopy to visualize the trachea (windpipe) if necessary to detect abnormalities.
Service type: Diagnostic and airway management procedure involving direct visualization and aspiration
Typical site of service: Operating room or procedure suite; may also occur in an emergency department or inpatient setting depending on clinical need
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult or pediatric patient presenting with acute airway compromise, persistent stridor, suspected foreign body in the larynx or trachea, copious secretions with clinical aspiration risk, or unexplained hemoptysis. The workflow begins with triage and airway assessment in the emergency department, intensive care unit, or operating room. After obtaining informed consent and verifying indications and contraindications, the patient is positioned supine with appropriate monitoring and oxygenation. The provider administers topical anesthesia and sedation or general anesthesia per airway assessment and clinical status. A direct laryngoscope is introduced to visualize the larynx; suction is performed to aspirate secretions, blood, or foreign material. If indicated, tracheoscopy is performed during the same session to inspect the trachea for obstruction, injury, or retained material. Specimens may be collected for culture or cytology. Post-procedure, the patient is observed for airway patency, bleeding, respiratory status, and need for further intervention such as bronchoscopy or surgical airway. Typical sites of service include the emergency department, intensive care unit, and operating room. The service type is direct laryngoscopy with aspiration of material and optional tracheoscopy under direct visualization.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When reporting only the physician’s interpretation or professional service separate from technical facility resources |