Summary & Overview
CPT 31573: Flexible Laryngoscopy with Laryngeal Injection
CPT code 31573 denotes a flexible fiberoptic laryngoscopic procedure in which a clinician inspects the larynx and injects a chemical agent (for example, botulinum toxin or a corticosteroid) into one side of the larynx. The service has both diagnostic and therapeutic applications: it identifies structural or functional abnormalities and delivers targeted treatment for conditions such as spasmodic dysphonia or focal swelling that leads to stenosis and hoarseness. Nationally, this procedure is commonly performed in outpatient and office settings by otolaryngologists and speech-related specialists, and it has implications for access to specialty care and coverage policies for injectable laryngeal therapies.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a succinct clinical context for the procedure, the typical sites of service, and payer considerations. The publication also summarizes common billing modifiers and related administrative details when available, highlights where input data are missing, and frames benchmarking and policy topics relevant to coverage, coding consistency, and site-of-service distinctions. This overview is intended for clinicians, billing professionals, and policy stakeholders seeking a concise reference on CPT code 31573 and its operational and reimbursement context.
Billing Code Overview
CPT code 31573 describes a diagnostic and therapeutic procedure using a flexible laryngoscope to visualize the larynx (voice box) and deliver a chemical injection (for example, botulinum toxin or a corticosteroid) into one side of the larynx. The procedure is used to treat laryngeal muscle spasms such as spasmodic dysphonia and to reduce swelling or inflammation that can cause stenosis and hoarseness.
Service type: Endoscopic laryngeal examination with injection (diagnostic and therapeutic)
Typical site of service: Office or outpatient clinic, ambulatory surgery center, or hospital outpatient department, where flexible fiberoptic laryngoscopy and targeted laryngeal injection can be performed safely under visualization.
Clinical & Coding Specifications
Clinical Context
A 48-year-old patient presents to an otolaryngology clinic with progressively worsening voice breaks, strained voice, and intermittent breathy dysphonia consistent with suspected spasmodic dysphonia. The patient has undergone prior voice therapy with limited benefit. The clinician performs awake flexible transnasal laryngoscopy to visualize the larynx and injects botulinum toxin into the thyroarytenoid muscle on one side to reduce hyperadduction. The procedure is performed in an outpatient clinic procedure room with topical nasal anesthesia and decongestant, real-time visualization via a flexible laryngoscope, and electromyographic guidance as needed to confirm accurate needle placement. Post-procedure, the patient is observed briefly for airway compromise, given voice rest instructions, and scheduled for follow-up dosing adjustments.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal, documented preoperative and postoperative visits | Use when the physician provided the usual pre- and postoperative care in addition to the procedure. |
22 | Increased procedural services | Use when work, time, or complexity substantially exceeds the usual for the procedure and documentation supports the increased work. |