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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 different planes, specifically horizontal or vertical, depending on the location and extent of the cancer being treated. The latero-vertical hemilaryngectomy, represented by CPT® Code 31375, is specifically designed for cases where there is cancer affecting the anterior commissure, the vocal processes of the arytenoid cartilage, or glottic cancer. Prior to the surgery, a tracheostomy may be performed to facilitate anesthesia administration and ensure the patient's airway is secure during the procedure. The surgical approach involves making incisions in the neck to access the larynx, allowing for the removal of affected tissue while preserving as much healthy tissue as possible. This procedure is critical for patients with specific types of laryngeal cancer, as it aims to remove malignant tissue while maintaining vocal function to the greatest extent feasible.
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The latero-vertical hemilaryngectomy (CPT® Code 31375) is indicated for patients diagnosed with specific types of laryngeal cancer. The following conditions may warrant this surgical intervention:
The latero-vertical hemilaryngectomy procedure involves several critical steps to ensure effective removal of the cancerous tissue while preserving surrounding structures. The procedure begins with a vertical incision in the neck, extending inferiorly from the midline of a previously made transverse incision. This incision allows for adequate exposure of the larynx in the vertical plane below the glottis. Following this, the larynx is accessed through a transverse incision made in the cricothyroid membrane, which is located just below the glottis. The incision is then extended superiorly up to the thyroid notch, providing the surgeon with access to the affected areas of the larynx.
Once the larynx is entered, the physician carefully resects tissue from the midline back to the body of the arytenoid process, ensuring that the anterior commissure remains intact. The resection also includes tissue from the cricoid process to the vocal cord on the affected side. This meticulous approach is essential to remove all cancerous tissue while preserving as much functional laryngeal structure as possible.
After the latero-vertical hemilaryngectomy, patients typically require close monitoring in a recovery setting. Post-operative care may include pain management, monitoring for any signs of complications such as bleeding or infection, and ensuring the airway remains clear. Patients may also need to follow specific guidelines regarding speech therapy and vocal rehabilitation, as the procedure can impact vocal function. The recovery process will vary based on the extent of the surgery and the individual patient's health status, but ongoing follow-up with the healthcare team is crucial to assess healing and manage any long-term effects of the surgery.
| Short Descr | PARTIAL REMOVAL OF LARYNX | Medium Descr | PARTIAL LARYNGECTOMY HEMILARYNG LATEROVERTICAL | Long Descr | Partial laryngectomy (hemilaryngectomy); laterovertical | 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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). | 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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