FEES stands for Fiberoptic Endoscopic Evaluation of Swallowing. It is a diagnostic procedure performed by a specially trained Speech-Language Pathologist (SLP). A thin, flexible endoscope is gently passed through the nose to visualize pharyngeal and laryngeal structures during the swallow, allowing clinicians to directly observe whether food or liquid is entering the airway (aspiration) — which is often missed during bedside assessments.

FEES allows an instrumental swallowing evaluation to be performed at the patient's facility, eliminating transportation and allowing assessment in the patient's usual environment. FEES also provides real-time visualization without radiation. Depending on the clinical question, an MBSS may still be the more appropriate study — Melanie can help determine which evaluation is most appropriate.

A referring physician must provide a written order for the FEES procedure (CPT code 92612). The need for the evaluation is typically identified by a Speech-Language Pathologist, Registered Nurse, Dietitian, or Physician based on clinical signs of dysphagia such as coughing during meals, unexplained weight loss, recurrent aspiration pneumonia, or a patient's self-reported difficulty swallowing.

FEES is a minimally invasive, well-tolerated procedure with an excellent safety record, performed following strict infection control protocols. Potential side effects are rare but may include mild nasal discomfort or, very rarely, a vasovagal response. We review each patient's medical history prior to the evaluation and will advise if any contraindications exist.

A typical FEES evaluation takes approximately 30–45 minutes from setup to completion, including chart review, patient preparation, the procedure itself, and equipment disinfection. Results and preliminary recommendations are shared with your facility representative immediately following the evaluation, with a full written report shortly thereafter.