Summary & Overview
CPT 31561: Direct Laryngoscopy with Arytenoidectomy
CPT code 31561 denotes a microlaryngoscopic procedure: direct laryngoscopy with arytenoidectomy performed under operating telescope or microscope. Nationally, this code captures surgical management of posterior laryngeal pathology that may affect airway patency or voice function and is relevant to otolaryngology, head and neck surgery, and anesthesia services. The code is used across inpatient and outpatient surgical settings and has implications for facility, professional, and anesthesia billing.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical description, typical sites of service, commonly applied modifiers, and the payer mix covered. The summary highlights where this code is applied clinically — in operating rooms or ambulatory surgery centers using endoscopic visualization — and outlines the operational billing context for surgical teams and revenue cycle professionals.
This publication provides benchmarks and policy-relevant details useful for coding accuracy, claim submission planning, and payer negotiation contexts. It also provides clinical context for when the procedure is indicated and how it maps to surgical service lines. Data not available in the input is noted where relevant.
Billing Code Overview
CPT code 31561 describes direct laryngoscopy with excision of arytenoid cartilage (arytenoidectomy) performed under visualization with an operating telescope or microscope. The procedure involves using a laryngoscope to inspect the larynx (voice box) and surgically remove the arytenoid cartilage to address structural abnormalities affecting the posterior larynx.
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Service type: Endoscopic laryngeal surgical procedure (direct laryngoscopy with arytenoidectomy)
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Typical site of service: Operating room or procedure suite in a hospital or ambulatory surgery center where endoscopic microlaryngoscopic procedures are performed.
Clinical & Coding Specifications
Clinical Context
A 62-year-old male with progressive hoarseness, intermittent aspiration, and inspiratory stridor is evaluated by an otolaryngologist. Office flexible laryngoscopy demonstrates posterior glottic stenosis with immobile arytenoid cartilage contributing to airway compromise and poor voice quality. The patient is scheduled for direct laryngoscopy with operative arytenoidectomy under general anesthesia using an operating telescope/microscope to improve glottic airway and phonation.
Preoperative workflow includes history and physical, airway assessment, informed consent discussing risks (bleeding, aspiration, voice change), and anesthesia evaluation. In the operating room, the surgeon performs direct laryngoscopy with a laryngoscope for visualization; microsurgical instruments and an operating microscope/telescope are used to excise the arytenoid cartilage (arytenoidectomy). Hemostasis is achieved, and the airway is reassessed. Postoperative workflow includes PACU monitoring, voice rest instructions, swallow evaluation as indicated, and follow-up laryngoscopic exam to confirm airway patency and healing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the surgeon's professional service is billed separate from technical facility services. |