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Official Description

Laryngoscopy direct, with or without tracheoscopy; diagnostic, with operating microscope or telescope

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 31526 refers to a direct laryngoscopy procedure that may include tracheoscopy, performed for diagnostic purposes using an operating microscope or telescope. This procedure allows healthcare professionals to visualize the larynx and surrounding structures in detail. The direct laryngoscope, which can be either a rigid angled scope or a flexible scope, is utilized to examine various anatomical areas, including the nasopharynx, oral cavity, oropharynx, hypopharynx, and larynx. The choice between a flexible or rigid scope depends on the specific clinical scenario; the flexible scope is typically inserted through the nostril, while the rigid scope is inserted through the mouth. During the examination, the physician looks for signs of abnormalities or injuries, such as lacerations, lesions, strictures, or other pathological conditions. Additionally, the procedure may involve advancing the scope into the trachea for further evaluation. The use of an operating microscope or telescope enhances the visualization capabilities, allowing for a more detailed assessment of tissues and any identified lesions or abnormalities. This code is specifically applicable when such advanced visualization tools are employed during the diagnostic laryngoscopy.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 31526 is indicated for various clinical scenarios where detailed visualization of the larynx and surrounding structures is necessary. The following conditions may warrant the use of this diagnostic laryngoscopy:

  • Abnormalities in the Larynx - This includes the presence of lesions, lacerations, or other structural irregularities that may affect the function of the larynx.
  • Strictures - Narrowing of the laryngeal passage that may cause breathing difficulties or voice changes.
  • Suspicion of Tumors - Evaluation of potential neoplastic growths within the larynx or surrounding areas.
  • Injury Assessment - Examination following trauma to the neck or throat that may have impacted the laryngeal structures.
  • Chronic Hoarseness - Persistent changes in voice quality that require investigation to determine underlying causes.

2. Procedure

The procedure for CPT® Code 31526 involves several key steps to ensure a thorough examination of the larynx and trachea. The following procedural steps are typically followed:

  • Step 1: Patient Preparation - The patient is positioned appropriately, often in a supine position, to facilitate access to the airway. Anesthesia may be administered to ensure comfort during the procedure.
  • Step 2: Scope Selection - The physician selects either a rigid angled scope or a flexible scope based on the clinical requirements. The choice of scope will influence the approach to visualization.
  • Step 3: Insertion of the Scope - If a flexible scope is used, it is gently inserted through the nostril, while a rigid scope is inserted through the mouth. Care is taken to navigate the anatomical structures without causing trauma.
  • Step 4: Visualization - The physician advances the scope to visualize the nasopharynx, oral cavity, oropharynx, hypopharynx, and larynx. The use of an operating microscope or telescope enhances the clarity and detail of the visualization.
  • Step 5: Examination and Assessment - The physician inspects the laryngeal structures for any abnormalities, such as lesions, strictures, or signs of injury. If necessary, biopsies or other interventions may be performed during this step.
  • Step 6: Withdrawal of the Scope - After the examination is complete, the scope is carefully withdrawn, and the patient is monitored for any immediate post-procedure complications.

3. Post-Procedure

Following the diagnostic laryngoscopy performed under CPT® Code 31526, patients may require specific post-procedure care. It is essential to monitor the patient for any signs of complications, such as bleeding or respiratory distress. Patients may experience temporary hoarseness or throat discomfort, which is generally expected and should resolve within a short period. Instructions regarding voice rest and hydration may be provided to facilitate recovery. Additionally, any biopsy results or further diagnostic findings should be communicated to the patient in a timely manner, and follow-up appointments may be scheduled to discuss the results and any necessary treatment plans.

Short Descr DX LARYNGOSCOPY W/OPER SCOPE
Medium Descr LARYNGOSCOPY W/WO TRACHEOSCOPY W/MICRO/TELESCOPE
Long Descr Laryngoscopy direct, with or without tracheoscopy; diagnostic, with operating microscope or telescope
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P8H - Endoscopy - laryngoscopy
MUE 1
CCS Clinical Classification 35 - Tracheoscopy and laryngoscopy with biopsy
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
GC This service has been performed in part by a resident under the direction of a teaching physician
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
74 Discontinued out-patient hospital/ambulatory surgery center (asc) procedure after administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier 74. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CG Policy criteria applied
CR Catastrophe/disaster related
GA Waiver of liability statement issued as required by payer policy, individual case
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
SG Ambulatory surgical center (asc) facility service
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2006-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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