CG-SURG-56 Diagnostic Fiberoptic Flexible Laryngoscopy

This policy addresses diagnostic fiberoptic flexible laryngoscopy (FFL). It is medically necessary when the larynx/pharynx cannot be adequately visualized by transoral mirror and at least one of the following applies: evaluation of symptomatic disorders of the voice, swallowing, or upper aerodigestive tract (including obstructive sleep disorders); preoperative assessment of vocal cord function before surgeries that risk injury to the recurrent laryngeal or vagus nerves (e.g., thyroid, anterior cervical spine, carotid procedures); or further evaluation of abnormalities found on other tests (CT, MRI, bronchoscopy, EGD). FFL is not medically necessary when these criteria are not met.

"Diagnostic fiberoptic flexible laryngoscopy is consideredmedically necessarywhen ALL of the following are met:"

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