Summary & Overview
CPT 31560: Direct Laryngoscopy with Arytenoidectomy
CPT code 31560 denotes direct laryngoscopy with excision of the arytenoid cartilage (arytenoidectomy), a surgical procedure used to address posterior glottic obstruction, airway compromise, or select laryngeal lesions. Nationally, this code captures a specialized otolaryngology operative service that affects surgical utilization, hospital and ambulatory surgery center case mix, and payer coverage policies for airway and voice-preserving interventions.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for Arytenoidectomy, typical sites of care, and the service type. The publication also summarizes payer coverage themes, common billing modifiers in practice (listed separately), and benchmarks where available. Policy and reimbursement updates affecting coverage criteria, prior authorization, and site-of-service considerations are highlighted to inform billing, coding, and administrative stakeholders.
This national overview supplies clinical context and coding clarity for hospital and ambulatory surgical administrators, otolaryngologists, and revenue cycle teams seeking to align documentation and billing practices with payer expectations.
Billing Code Overview
CPT code 31560 describes direct laryngoscopy with excision of the arytenoid cartilage (arytenoidectomy). The procedure uses a laryngoscope to visualize the larynx (voice box) and surgically remove one or more arytenoid cartilages to treat obstructive, neoplastic, or functional disorders of the posterior glottis.
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Service type: Direct laryngoscopy with operative excision (surgical airway/upper aerodigestive tract procedure)
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Typical site of service: Operating room or ambulatory surgery center, often performed by an otolaryngologist (ENT) under general anesthesia
Clinical & Coding Specifications
Clinical Context
A 58-year-old male presents with progressive hoarseness, inspiratory stridor, and difficulty swallowing. Flexible laryngoscopy in the clinic identifies immobility and deformity of the arytenoid region with mucosal overgrowth suspected to be causing airway compromise and aspiration. The otolaryngologist schedules direct laryngoscopy with arytenoidectomy under general anesthesia to visualize the larynx with a rigid laryngoscope, confirm the lesion, excise the affected arytenoid cartilage, and restore airway patency and improved vocal fold function. Typical workflow includes preoperative evaluation, general endotracheal anesthesia, direct laryngoscopy with operative microscope or endoscope, excision of arytenoid cartilage (partial or complete arytenoidectomy), hemostasis, possible specimen submission to pathology, and postoperative airway monitoring in post-anesthesia care unit or same-day discharge if stable.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or complexity substantially exceeds typical for arytenoidectomy (extensive dissection, prolonged operative time) |
26 | Professional component | Use when billing only the physician professional portion and technical component billed separately |
50 | Bilateral procedure | Use if arytenoidectomy is performed on both sides during the same operative session |
51 | Multiple procedures | Use when additional distinct procedures are performed in the same session (e.g., microlaryngeal surgery plus arytenoidectomy) |
52 | Reduced services | Use when the procedure is partially reduced or not completed as planned |
53 | Discontinued procedure | Use when the procedure is started but terminated for patient-related or clinical reasons before completion |
62 | Two surgeons | Use when two surgeons of different specialties perform distinct portions of the arytenoidectomy concurrently |
66 | Surgical team (e.g., multiple surgeons) | Use when a surgical team approach is required for complex airway reconstruction involving arytenoidectomy |
73 | Discontinued outpatient procedure prior to anesthesia | Use when the outpatient arytenoidectomy is cancelled after patient prepared but before anesthesia induction |
78 | Return to OR for related procedure during postoperative global period | Use when a related operative intervention for complications of arytenoidectomy occurs during the global period |
80 | Assistant surgeon | Use when a surgical assistant performs part of the procedure and separate assistant allowance is reported |
81 | Minimum assistant surgeon | Use when a minimal assistant surgeon contribution is documented |
82 | Assistant surgeon when qualified resident not available | Use when an assistant surgeon is used because a qualified resident is not available |
TC | Technical component | Use when billing only the technical component (e.g., hospital charges) separate from the professional component |
LT | Left side | Use to indicate procedure performed on the left arytenoid when laterality reporting is required |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 2084S | Otolaryngology (ENT) | Primary specialty performing laryngoscopy with arytenoidectomy |
| 207Y00000X | Head and Neck Surgery | Surgeons specializing in complex airway and laryngeal reconstruction |
| 207L00000X | General Surgery | Occasionally involved for multidisciplinary airway procedures |
| 207K00000X | Thoracic Surgery | Involved when concurrent tracheal surgery or airway reconstruction is required |
| 363L00000X | Anesthesiology | Provides general anesthesia and perioperative airway management |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
J38.2 | Vocal cord and larynx disease, unspecified | May indicate laryngeal pathology affecting arytenoid region leading to surgery |
J38.3 | Paralysis of vocal cords and larynx | Vocal fold immobility with arytenoid dysfunction often prompts arytenoidectomy for airway/voice improvement |
J37.9 | Chronic laryngitis, unspecified | Chronic inflammation affecting arytenoids that may require surgical excision if refractory to medical therapy |
R49.0 | Dysphonia | Symptom commonly associated with arytenoid lesions or immobility prompting diagnostic and surgical intervention |
J95.1 | Tracheostomy complication | Postoperative airway issues or scarring involving arytenoids may necessitate arytenoidectomy in select cases |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
31575 | Laryngoscopy, direct, with biopsy | Performed when suspicious lesions on arytenoid are biopsied during direct laryngoscopy prior to or instead of full arytenoidectomy |
31531 | Laryngoscopy, flexible fiberoptic, diagnostic | Often performed preoperatively in clinic to evaluate vocal folds and arytenoids before scheduling direct laryngoscopy with arytenoidectomy |
31505 | Laryngoscopy, indirect or with mirror | Used as an initial diagnostic assessment; less commonly therapeutic for arytenoid pathology |
31622 | Bronchoscopy, rigid; diagnostic, with or without cell washing | May be performed when concurrent airway evaluation of subglottic or tracheal pathology is needed during arytenoidectomy |
88305 | Level IV surgical pathology, gross and microscopic exam | Used for histopathologic examination of excised arytenoid tissue when specimen is submitted to pathology |