microlaryngoscopy

DEFINITION of microlaryngoscopy

A procedure performed under general anesthesia in which a rigid laryngoscope is suspended to provide hands-free access to the larynx, and an operating microscope is used to achieve high magnification of laryngeal structures. This allows precise visualization and surgical manipulation of vocal cords and surrounding tissues for diagnostic or therapeutic purposes. It is the gold-standard approach for most benign vocal cord lesion removal and laryngeal microsurgery.

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ETYMOLOGY of microlaryngoscopy

greek **Micro- **Greek mikros Small / magnified Laryngo- Greek larynx The larynx (voice box) -scopy Greek skopein To examine / to look

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Related Terms

• Laryngoscopy — broader term; includes indirect and flexible methods
• Suspension Laryngoscopy — the setup technique used during microlaryngoscopy
• Phonosurgery — surgery to improve or restore voice
• Panendoscopy — combined scope exam of larynx, esophagus, and bronchi
• Laryngoplasty — reconstructive laryngeal surgery
• Vocal Cord Stripping — older technique; removal of vocal cord epithelium
• Cold Steel Excision — instrument-based (non-laser) lesion removal
• KTP / CO₂ Laser Laryngoscopy — laser energy used instead of/alongside cold instruments
• Stroboscopy — functional vocal cord assessment, often done pre/post-op
• Tracheoscopy — related scope exam of the trachea

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CODING AND NUANCES

CPT Codes

These are the -with operating microscope or telescope variants — the true microlaryngoscopy codes:

CPT Code	Description
31531	Laryngoscopy, direct, operative; foreign body removal with operating microscope
31536	Laryngoscopy, direct, operative; with biopsy with operating microscope
31541	Laryngoscopy, direct, operative; excision of tumor and/or stripping of vocal cord(s) or epiglottis with operating microscope
31545	Direct operative laryngoscopy with microscope; submucosal removal of non-neoplastic lesion(s), with reconstruction using local tissue flap(s)
31546	Same as 31545, with reconstruction using other than local tissue flap
31561	Laryngoscopy, direct, operative; with arytenoidectomy with operating microscope
31571	Laryngoscopy, direct, operative; with injection into vocal cord(s) with operating microscope

Note: The "without microscope" counterparts (31530, 31535, 31540, 31560, 31570) are direct laryngoscopy only and should not be coded when a microscope is documented.

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ICD-10-CM Diagnosis Codes

(Codes represent the most common diagnoses leading to microlaryngoscopy)

ICD-10 Code	Description
J38.1	Polyp of vocal cord and larynx
J38.2	Nodules of vocal cords
J38.3	Other diseases of vocal cords (includes granuloma, leukoplakia, pachyderma)
J38.4	Edema of larynx (includes Reinke’s edema)
J38.6	Stenosis of larynx
J38.00	Paralysis of vocal cords and larynx, unspecified
J38.01	Paralysis of vocal cords and larynx, unilateral
J38.02	Paralysis of vocal cords and larynx, bilateral
D14.1	Benign neoplasm of larynx
C32.0	Malignant neoplasm of glottis
C32.1	Malignant neoplasm of supraglottis
C32.2	Malignant neoplasm of subglottis
C32.9	Malignant neoplasm of larynx, unspecified
B08.5	Enteroviral vesicular pharyngitis (recurrent respiratory papillomatosis workup)
D10.5	Benign neoplasm of other parts of oropharynx

7th Character Note: These laryngeal/vocal cord ICD-10 codes are complete as listed — a 7th character extension is not applicable to this code set. 7th characters are required primarily for trauma (S/T codes) and certain obstetric/neonatal categories.

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Coding tip (Inpatient): When microlaryngoscopy is the principal procedure, confirm documentation specifies "operating microscope" or "microscopic technique" — this distinction drives the code selection (e.g., 31541 vs. 31540). Laser use (CO₂, KTP) may be separately documented but is generally bundled.

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DERIVATIONS of microlaryngoscopy

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Query functionality

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Med roots Appendix A Prefixes Appendix B Combining Forms Appendix C Suffixes Appendix D Suffix forms