The Roles of Flexible Laryngoscopy Videostroboscopy

Flexible fiberoptic and telescopic diagnostic laryngoscopy (31575) and flexible and/or rigid strobovideolaryngoscopy (31579) are well established diagnostic procedures that are medically indicated for the diagnosis of voice, swallowing, and airway disorders.

Each procedure requires the application of distinct endoscopy skills, training and judgment. These endoscopic procedures offer unique information in the functional and anatomic assessment of the upper airway. In most cases, these examinations can be performed in the office without taking the patient to the operating room or the endoscopy suite. These procedures are effective in diagnosis and management of otolaryngic disorders and they are not investigational. Some patients may require one or more of these diagnostic procedures performed individually or sequentially. The extended nature of examination of the structure and function of the upper aerodigestive tract is often comprehensive and complex. The endoscopic evaluation of the upper airway should not be considered part of the routine office examination.

• Flexible laryngoscopy or videostroboscopy should not be considered a routine part of an office visit.
• Flexible laryngoscopy or videostroboscopy should not be required to be done as a separate return visit.
• Flexible laryngoscopy or videostroboscopy should not be mandated to be performed in a separate endoscopy suite or outpatient surgery center in order to be reimbursed.

Clearly defined clinical indicators based on ICD-9 diagnostic code groups have been developed in the literature to support the above positions.

Adopted 9/10/1997
Submitted for Review 3/1/98
Reaffirmed 3/1/98
Reviewed 9/26/05

Guidelines are not a substitute for the experience and judgment of a physician and are developed to enhance the physicians' ability to practice evidence-based medicine.

Important Notice

The American Academy of Otolaryngology-Head and Neck Surgery, Inc. and Foundation (AAO-HNS/F) Policy Statements are guidelines only. In no sense do they represent a standard of care. The applicability of an indicator for a procedure, and/or of the process or outcome criteria, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. Adherence to these guidelines will not ensure successful treatment in every situation. The AAO-HNS emphasizes that these policies should not be deemed inclusive of all proper treatment decisions or methods of care, nor exclusive of other treatment decisions or methods of care reasonably directed to obtaining the same results

The Roles of Flexible Laryngoscopy Videostroboscopy in the Office Evaluation and Management of Patients with Otolaryngic Disorders