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Official Description

Section recurrent laryngeal nerve, therapeutic (separate procedure), unilateral

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

A therapeutic unilateral section of the recurrent laryngeal nerve is a surgical procedure aimed at addressing spastic dysphonia, a condition characterized by a severe vocal disability where the vocal cords are positioned too closely together, leading to difficulties in voice production. This procedure is classified as a separate procedure, meaning it is performed independently and not as part of a larger surgical intervention. The recurrent laryngeal nerve, which plays a crucial role in controlling the muscles of the larynx, is targeted during this operation. By sectioning the nerve on one side, the procedure induces paralysis of the involved vocal cord, allowing it to retract away from the midline. This retraction helps to alleviate the constriction of the vocal cords, ultimately resulting in improved voice quality for the patient. The surgical approach involves making an incision in the skin of the neck, followed by careful dissection of the soft tissues to access the thyroid gland and the recurrent laryngeal nerve located in the tracheoesophageal groove. The procedure concludes with the division of the nerve and the layered closure of the overlying soft tissues and skin.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The therapeutic unilateral section of the recurrent laryngeal nerve is indicated for the treatment of specific conditions that affect vocal function. The primary indication for this procedure is:

  • Spastic Dysphonia - A severe vocal disability characterized by abnormal voice production due to excessive tension in the vocal cords, resulting in a strained or strangled voice quality.

2. Procedure

The procedure involves several critical steps to ensure successful sectioning of the recurrent laryngeal nerve. Each step is performed with precision to minimize complications and achieve the desired outcome.

  • Step 1: Incision - The procedure begins with the surgeon making an incision in the skin of the neck, either on the right or left side, depending on the side of the recurrent laryngeal nerve that is to be sectioned. This incision allows access to the underlying structures.
  • Step 2: Dissection - Following the incision, the surgeon carefully dissects the soft tissues to expose the thyroid gland. This step is crucial for identifying the anatomical landmarks necessary for locating the recurrent laryngeal nerve.
  • Step 3: Mobilization of the Thyroid Lobe - The surgeon then mobilizes the right or left lobe of the thyroid gland to gain better access to the recurrent laryngeal nerve, which is situated in the tracheoesophageal groove.
  • Step 4: Identification of the Nerve - Once the thyroid lobe is mobilized, the recurrent laryngeal nerve is identified. This step requires careful attention to avoid damaging surrounding structures.
  • Step 5: Sectioning of the Nerve - The recurrent laryngeal nerve is then divided (sectioned), which leads to paralysis of the involved vocal cord. This action is intended to alleviate the symptoms of spastic dysphonia.
  • Step 6: Closure - After the nerve has been sectioned, the surgeon proceeds to close the overlying soft tissues and skin in layers, ensuring proper healing and minimizing scarring.

3. Post-Procedure

Post-procedure care involves monitoring the patient for any immediate complications related to the surgery. Patients may experience temporary hoarseness or changes in voice quality as the body adjusts to the nerve sectioning. Follow-up appointments are essential to assess the recovery process and the effectiveness of the procedure in improving voice quality. Patients are typically advised on voice rest and may receive guidance on vocal rehabilitation to optimize their recovery and vocal function.

Short Descr LARYNX NERVE SURGERY
Medium Descr SECTION RECURRENT LARYNGEAL NERVE THER UNI SPX
Long Descr Section recurrent laryngeal nerve, therapeutic (separate procedure), unilateral
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
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
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE Not applicable/unspecified.
CCS Clinical Classification 9 - Other OR therapeutic nervous system procedures
Date
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2019-01-01 Deleted Code deleted
Pre-1990 Added Code added.
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