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Official Description

Flexible endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording;

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Flexible endoscopic evaluation of swallowing function and laryngeal sensory testing is a diagnostic procedure that utilizes advanced imaging techniques to assess the mechanics of swallowing and the sensory capabilities of the larynx. This procedure is conducted using a flexible endoscope, which is a thin, tube-like instrument equipped with a camera and light source, allowing for a detailed view of the throat and laryngeal structures. The evaluation is performed while the patient is seated, ensuring comfort and optimal positioning for the procedure. Prior to the insertion of the endoscope, local anesthesia may be applied to the nasal passages and throat using an analgesic spray, minimizing discomfort during the examination. During the evaluation, the endoscope is carefully inserted through the nose or mouth and advanced into the throat, reaching the hypopharynx where critical anatomical structures can be visualized. The procedure involves the ingestion of both liquid and solid food while cine or video recordings capture the swallowing process in real-time. This allows for a comprehensive assessment of various aspects of swallowing function, including the ability to protect the airway, the timing of swallowing movements, and the effectiveness of bolus clearance from the pharynx. Additionally, laryngeal sensory testing is performed by delivering puffs of air through the endoscope, which helps evaluate the sensory function of the pharyngeal and laryngeal areas. The entire procedure is documented through video recordings, and a detailed written report of the findings is generated for further analysis and clinical decision-making.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The flexible endoscopic evaluation of swallowing and laryngeal sensory testing is indicated for a variety of clinical scenarios where assessment of swallowing function and laryngeal sensitivity is necessary. The following conditions may warrant this procedure:

  • Dysphagia - Difficulty swallowing, which may be due to structural or functional abnormalities.
  • Neurological disorders - Conditions such as stroke, Parkinson's disease, or multiple sclerosis that can affect swallowing mechanics.
  • Recurrent aspiration - Frequent aspiration of food or liquids into the airway, which can lead to pneumonia or other respiratory complications.
  • Voice changes - Alterations in voice quality that may be related to laryngeal dysfunction.
  • Post-surgical evaluation - Assessment following surgeries involving the throat or larynx to ensure proper healing and function.

2. Procedure

The flexible endoscopic evaluation of swallowing and laryngeal sensory testing involves several key procedural steps that ensure a thorough assessment of the patient's swallowing function and laryngeal sensitivity. The following steps outline the procedure:

  • Preparation of the patient - The patient is positioned comfortably in a seated position to facilitate the procedure. Local anesthesia is administered to the nasal passages and throat using an analgesic spray to minimize discomfort during the endoscopic examination.
  • Insertion of the endoscope - A flexible endoscope is carefully inserted through the patient's nose or mouth and advanced into the throat, reaching the hypopharynx. This allows for visualization of the laryngeal and pharyngeal structures.
  • Swallowing function assessment - The patient is instructed to ingest various consistencies of food, including liquids and solids, while cine or video recordings capture the swallowing process. The clinician observes and evaluates the patient's ability to protect the airway, the timing of swallowing movements, and the clearance of the bolus from the pharynx.
  • Laryngeal sensory testing - Puffs of air are delivered through the endoscope into the throat to assess the sensory function of the laryngeal and pharyngeal structures. This testing is conducted concurrently with the swallowing function assessment, and cine or video images are recorded for analysis.
  • Review and reporting - After the procedure, the recorded images are reviewed, and a comprehensive written report detailing the findings is generated for the clinician's review and further management of the patient.

3. Post-Procedure

Following the flexible endoscopic evaluation of swallowing and laryngeal sensory testing, patients may experience some temporary discomfort in the throat due to the procedure. It is important for the clinician to provide post-procedure care instructions, which may include recommendations for hydration and dietary modifications if necessary. Patients should be monitored for any signs of complications, such as persistent pain, difficulty breathing, or swallowing difficulties. The written report generated from the procedure will guide further clinical decisions and management strategies based on the findings observed during the evaluation.

Short Descr FEES W/LARYNGEAL SENSE TEST
Medium Descr FLEXIBLE NDSC EVAL SWLNG&LARYN SENS C/V REC
Long Descr Flexible endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording;
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 0 - No 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) 0 - 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 Service Paid under Fee Schedule or Payment System other than OPPS
Type of Service (TOS) 1 - Medical Care
Berenson-Eggers TOS (BETOS) P8I - Endoscopy - other
MUE 1
CCS Clinical Classification 31 - Diagnostic procedures on nose, mouth and pharynx
GN Services delivered under an outpatient speech language pathology plan of care
KX Requirements specified in the medical policy have been met
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
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.
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.)
GC This service has been performed in part by a resident under the direction of a teaching physician
GO Services delivered under an outpatient occupational therapy plan of care
GW Service not related to the hospice patient's terminal condition
GX Notice of liability issued, voluntary under payer policy
U5 Medicaid level of care 5, as defined by each state
Date
Action
Notes
2017-01-01 Changed Long and Medium descriptions changed.
2010-01-01 Changed Code description changed.
2003-01-01 Added First appearance in code book in 2003.
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