Summary & Overview
CPT 31574: Flexible Laryngoscopy with Vocal Fold Injection
CPT code 31574 defines a combined diagnostic and therapeutic procedure in which a flexible laryngoscope is used to inspect the larynx and inject one vocal fold with a temporary or permanent filler. This procedure addresses vocal fold immobility or tissue loss due to paralysis, atrophy, or scarring and is an important tool for restoring glottic competence and improving voice and airway function. Nationally, CPT code 31574 is relevant to otolaryngology practices, ambulatory surgical centers, and hospital outpatient departments that manage voice disorders and shared airway conditions.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides clinical context for when the service is used, typical sites of service, and operational considerations relevant to coding and billing.
Readers will find benchmarks where available, a concise review of clinical indications tied to the code description, and notes on common modifiers and payer considerations. The content is designed to support coding accuracy, payer communications, and administrative planning without providing clinical recommendations.
Billing Code Overview
CPT code 31574 describes a diagnostic and therapeutic procedure using a flexible laryngoscope to visualize the larynx (voice box) and perform an injection into one vocal fold with a temporary or permanent filler. The injection is intended to medially augment the affected vocal fold to treat full or partial vocal fold paralysis, atrophy, or scarring, with the goal of improving glottic closure and voice function.
Service type: Endoscopic laryngoscopy with vocal fold injection (office or ambulatory surgical procedure).
Typical site of service: Otolaryngology clinic, ambulatory surgery center, or hospital outpatient department.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with unilateral vocal fold paralysis presents with progressive hoarseness, effortful phonation, and reduced vocal projection following thyroid surgery six months earlier. Laryngoscopic examination demonstrates a paralyzed right vocal fold in a paramedian position with incomplete glottic closure and compensatory left vocal fold strain. After discussion of options, the otolaryngologist schedules an in-office flexible laryngoscopy with vocal fold injection augmentation under topical anesthesia using a flexible laryngoscope and filler material to medialize the paralyzed fold.
The clinical workflow includes pre-procedure voice assessment and consent, topical anesthesia of the nasal passages and pharynx, flexible laryngoscopic visualization of the larynx, targeted injection of temporary or permanent filler into the affected vocal fold, immediate post-injection phonatory assessment, and brief post-procedure observation. The typical site of service is an otolaryngology clinic or ambulatory surgical center equipped for in-office laryngoscopy. Typical personnel include the performing otolaryngologist (or laryngologist), a nurse or medical assistant to assist with equipment and patient monitoring, and billing/clinical documentation staff to record the procedure, diagnosis, and any applicable modifiers.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Physician office/facility standard service | Use when the service is performed without unusual circumstances in the provider’s typical setting. |