31575
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
0.92
Facility
$61.12
Non-Facility
$127.26
Key Coverage Criteria
- Diagnostic fiberoptic flexible laryngoscopy is consideredmedically necessarywhen ALL of the following are met:
- Larynx, pharynx, and related structures are not adequately visualized by the transoral mirror;and
- Any of the following indications apply:Diagnosis of symptomatic disorders involving the voice, swallowing, and upper aerodigestive tract, including obstructive sleep disorders;orPreoperative evaluation of vocal cord function for individuals undergoing surgery where the recurrent laryngeal or vagus nerves are at risk of injury (for example, thyroid, anterior cervical spine or carotid procedures);orFurther evaluation of abnormalities of the upper aerodigestive tract discovered by another modality, [...]
- Diagnosis of symptomatic disorders involving the voice, swallowing, and upper aerodigestive tract, including obstructive sleep disorders;or
- Preoperative evaluation of vocal cord function for individuals undergoing surgery where the recurrent laryngeal or vagus nerves are at risk of injury (for example, thyroid, anterior cervical spine or carotid procedures);or
- Further evaluation of abnormalities of the upper aerodigestive tract discovered by another modality, such as CT, MRI, bronchoscopy or EGD.
1 Active Policy
ANTHEM-CG-SURG-56 — CG-SURG-56 Diagnostic Fiberoptic Flexible Laryngoscopy
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