CPT® Code 92617

1. Indications

The flexible endoscopic evaluation of swallowing and laryngeal sensory testing is indicated for various conditions and symptoms that may affect swallowing function and laryngeal sensitivity. The following are explicitly provided indications for this procedure:

• Dysphagia Difficulty in swallowing, which may be due to various underlying conditions affecting the esophagus, throat, or neurological function.
• Neurological Disorders Conditions such as stroke, Parkinson's disease, or multiple sclerosis that may impair swallowing and airway protection mechanisms.
• Recurrent Aspiration Frequent aspiration of food or liquids into the airway, which can lead to aspiration pneumonia and other complications.
• Voice Changes Alterations in voice quality that may suggest laryngeal dysfunction or sensory impairment.
• Post-Surgical Evaluation Assessment following surgeries involving the throat or larynx to evaluate the integrity of swallowing function and airway protection.

2. Procedure

The procedure for flexible endoscopic evaluation of swallowing and laryngeal sensory testing involves several key steps, each critical for ensuring a comprehensive assessment of the patient's swallowing function and laryngeal sensitivity. The following procedural steps are outlined:

• Preparation of the Patient The patient is positioned in a seated manner to facilitate the procedure. Local anesthesia may be administered via an analgesic spray to numb the nasal passages and throat, ensuring the patient experiences minimal discomfort during the endoscopic evaluation.
• 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 direct visualization of the laryngeal and pharyngeal structures, which is essential for the evaluation.
• Swallowing Function Assessment The patient is instructed to ingest both liquid and solid food while cine or video images are recorded. During this phase, various aspects of swallowing function are assessed, including the ability to protect the airway, the timing of swallowing movements, and the trajectory of the food or liquid bolus as it is propelled through the hypopharynx. Observations are made regarding whether the bolus is completely cleared from the pharynx or if there is any pooling or residue following the swallow.
• Laryngeal Sensory Testing To evaluate laryngeal sensory function, puffs of air are delivered through the endoscope into the throat. This is done while cine or video images are recorded, allowing for the assessment of sensory responses in the pharyngeal and laryngeal structures during the swallowing function test.
• Review and Reporting After the completion of the evaluation, the recorded cine or video images are thoroughly reviewed. A detailed written report of the findings is generated, summarizing the results of the swallowing function assessment and laryngeal sensory testing.

3. Post-Procedure

Post-procedure care following the flexible endoscopic evaluation of swallowing and laryngeal sensory testing typically involves monitoring the patient for any immediate adverse reactions to the procedure, particularly if local anesthesia was used. Patients may be advised to avoid eating or drinking until the effects of the anesthesia have worn off to prevent choking or aspiration. The healthcare provider will review the findings from the evaluation with the patient, discussing any necessary follow-up actions or further assessments that may be required based on the results. Additionally, the written report generated from the procedure will be made available for the patient's medical records and for any further clinical decision-making.