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A partial laryngectomy, commonly known as a hemilaryngectomy, is a surgical procedure that involves the removal of a portion of the larynx, which is the voice box located in the throat. This procedure can be performed in two distinct planes: horizontal and vertical. The horizontal hemilaryngectomy, represented by CPT® Code 31370, is specifically indicated for cases of supraglottic cancer that affect only one side of the larynx (unilateral). In contrast, vertical hemilaryngectomies, which are categorized under different CPT codes, are utilized for cancers located in the anterior commissure, vocal processes of the arytenoid cartilage, or glottic cancer. Before the surgical intervention, a tracheostomy may be performed to facilitate the administration of anesthesia and ensure the patient's airway is secure. During the horizontal hemilaryngectomy, a transverse incision is made in the skin of the neck at the level of the thyroid cartilage, allowing access to the larynx. The procedure involves careful dissection and removal of the affected laryngeal tissue while preserving critical structures, such as the hypoglossal nerves. The surgical technique includes incisions through various anatomical landmarks, ultimately leading to the removal of the involved side of the larynx above the vocal cords. The closure of the surgical wound is performed by reapproximating the thyroid cartilage to the tongue base, followed by the placement of drains and closure of the skin incisions. This procedure is essential for managing specific laryngeal cancers while aiming to preserve as much function as possible in the remaining laryngeal structures.
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The partial laryngectomy (hemilaryngectomy) is indicated for specific conditions related to laryngeal cancer. The following are the explicitly provided indications for performing this procedure:
The procedure for a horizontal hemilaryngectomy (CPT® Code 31370) involves several detailed steps to ensure the effective removal of the affected laryngeal tissue while preserving surrounding structures. The following procedural steps are outlined:
After the horizontal hemilaryngectomy, patients may require specific post-procedure care to ensure proper recovery. This includes monitoring for any complications related to the surgery, such as infection or bleeding. Patients may also need assistance with breathing and swallowing, as the removal of part of the larynx can affect these functions. Follow-up appointments are essential to assess healing and to monitor for any signs of cancer recurrence. Additionally, speech therapy may be recommended to help patients regain their voice and improve communication following the procedure.
| Short Descr | PARTIAL REMOVAL OF LARYNX | Medium Descr | PARTIAL LARYNGECTOMY HEMILARYGECTOMY HORIZONTAL | Long Descr | Partial laryngectomy (hemilaryngectomy); horizontal | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard 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) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 42 - Other OR therapeutic procedures on respiratory system |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| Pre-1990 | Added | Code added. |
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