Summary & Overview
HCPCS Level II S2340: Chemodenervation of Vocal Cord Abductor Muscle
HCPCS Level II code S2340 represents chemodenervation of the abductor muscle(s) of the vocal cord, a targeted injection procedure used in management of specific laryngeal movement disorders. The code identifies a specialized outpatient procedural service that has implications for ambulatory surgical centers, otolaryngology and voice clinics, and payer coverage policies nationwide.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of national reimbursement context and clinical use for this procedure, including where the service is typically delivered and which stakeholders commonly engage with coverage and billing for this code. The publication summarizes benchmarking considerations, common billing modifiers, and clinical indications associated with chemodenervation of vocal cord abductor muscles.
This summary provides clinicians, billing professionals, and policy analysts with practical context on coding and service setting; it highlights contract and coverage touchpoints to review when submitting claims. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code S2340 describes chemodenervation of abductor muscle(s) of vocal cord. This service involves injection-based chemical denervation intended to reduce unwanted abductor muscle activity of the vocal cords, typically using neurolytic or neuromodulatory agents to alter laryngeal muscle function. The service type is a targeted laryngeal chemodenervation procedure. The typical site of service is an outpatient specialty setting such as an otolaryngology clinic, voice clinic, or ambulatory surgery center.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient presents to an otolaryngology clinic with progressive breathy voice and intermittent inspiratory stridor several weeks after a viral upper respiratory infection. Laryngoscopy demonstrates bilateral vocal fold abductor paresis with impaired opening during inspiration consistent with laryngeal dystonia affecting the posterior cricoarytenoid muscle complex. After assessment and informed consent, the patient is scheduled for an outpatient chemodenervation procedure targeting the abductor muscle(s) of the vocal cord using botulinum toxin. The procedure is performed in a minor procedure room or ambulatory surgery center under topical anesthesia and monitored sedation as needed. Flexible laryngoscopic guidance and electromyographic localization may be used to identify the abductor muscle(s). The clinician injects an appropriate dose of botulinum toxin into the target abductor muscle(s) to reduce paradoxical abduction activity and improve airway and voice symptoms. Post-procedure monitoring includes brief observation for respiratory compromise, discussion of expected transient side effects (voice weakness, aspiration risk), and scheduling of follow-up for outcome assessment and potential repeat injections.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Standard primary procedure indicator | Use when no modifier is required and the service is the primary procedure for the visit |