Summary & Overview
HCPCS Level II C9742: Flexible Fiberoptic Laryngoscopy with Vocal Cord Injection
HCPCS Level II code C9742 denotes a flexible fiberoptic laryngoscopy with therapeutic injection into the vocal cord(s), and includes diagnostic laryngoscopy when performed. Nationally, this code captures a common otolaryngology procedure used to treat vocal fold paralysis, glottic insufficiency, and select benign laryngeal lesions by delivering injectable materials directly into the vocal fold to improve voice and airway function. The code matters for payers and providers because it combines diagnostic visualization with a therapeutic intervention and is billed across outpatient clinic, ambulatory surgical center, and hospital outpatient settings.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise presentation of clinical context for the procedure, coding specifics tied to HCPCS Level II conventions, and the typical sites where the service is rendered. The analysis outlines what stakeholders need to know about billing capture for combined diagnostic/therapeutic laryngoscopy, common billing considerations, and where to look for payer policy and coverage guidance.
This summary is intended for a national audience of billing professionals, otolaryngology clinicians, and health policy analysts seeking a clear, practice-oriented overview of HCPCS Level II code C9742 and its role in coding and reimbursement workflows.
Billing Code Overview
HCPCS Level II code C9742 describes a flexible fiberoptic laryngoscopy with therapeutic injection into vocal cord(s), and includes a diagnostic laryngoscopy if performed. This procedure is a combined diagnostic and therapeutic endoscopic intervention performed using a flexible fiberoptic scope to visualize the larynx and deliver an injection directly into one or both vocal cords.
-
Service type: Therapeutic endoscopic laryngoscopy with injection (includes diagnostic laryngoscopy when performed)
-
Typical site of service: Outpatient otolaryngology clinic, ambulatory surgical center, or hospital outpatient department
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient presents to an otolaryngology clinic with progressive hoarseness and intermittent aspiration. Flexible transnasal laryngoscopy in clinic demonstrates a unilateral vocal fold paresis with a posterior gap and evidence of vocal fold atrophy. After discussion of options, the clinician performs an in-office flexible fiberoptic laryngoscopy with injection of a biocompatible filler into the affected vocal fold for medialization. The procedure includes topical anesthesia, flexible fiberoptic laryngoscope insertion, diagnostic evaluation of vocal fold mobility and glottic closure, and therapeutic injection into the vocal cord(s). Vital signs are monitored before, during, and after the procedure, and the patient is observed briefly for airway compromise and tolerated oral intake instructions are provided prior to discharge.
Typical workflow steps:
-
Pre-procedure evaluation and informed consent.
-
Application of topical anesthesia and vasoconstrictor spray to nasal passages.
-
Flexible fiberoptic laryngoscope insertion via the nasal cavity with diagnostic laryngoscopy performed.
-
Identification of target vocal fold and injection site under direct visualization.
-
Injection of the chosen implant material into the vocal fold for medialization.
-
Post-injection reassessment of vocal fold position and voice quality.
-
Short post-procedure observation and discharge with voice rest and follow-up instructions.