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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 is indicated primarily for patients with laryngeal cancer, particularly when the cancer is localized to one side of the larynx. The term "hemilaryngectomy" refers to the fact that only a part of the larynx is excised, as opposed to a total laryngectomy, which involves the complete removal of the larynx. The procedure can be performed in different planes, specifically horizontal or vertical, depending on the location and extent of the cancer. In the case of an antero-latero-vertical hemilaryngectomy, which is represented by CPT® Code 31382, the surgical approach is more extensive. This procedure not only involves the removal of tissue from one side of the larynx but also includes the excision of the anterior commissure, the entire vocal cord on the contralateral side, and the underlying cartilage. 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 complexity of this surgery necessitates careful planning and execution to preserve as much function as possible while effectively removing cancerous tissues.
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The antero-latero-vertical hemilaryngectomy (CPT® Code 31382) is indicated for specific conditions related to laryngeal cancer. The following are the primary indications for this procedure:
The antero-latero-vertical hemilaryngectomy involves several critical procedural steps to ensure the effective removal of cancerous tissues while attempting to preserve surrounding structures. The following steps outline the procedure:
Post-procedure care following an antero-latero-vertical hemilaryngectomy is essential for patient recovery and includes several considerations. Patients may require close monitoring in a recovery area to ensure stable vital signs and proper airway management due to the tracheostomy. Pain management is also a critical component of post-operative care, as patients may experience discomfort at the surgical site. Speech therapy may be necessary to assist patients in adapting to changes in their voice and swallowing function following the removal of significant laryngeal structures. Additionally, follow-up appointments are crucial for monitoring recovery, assessing for any complications, and ensuring that there are no signs of cancer recurrence. Nutritional support may be required, especially if swallowing is affected, and patients may need to follow a modified diet during their recovery period.
| Short Descr | PARTIAL REMOVAL OF LARYNX | Medium Descr | PARTIAL LARYNG HEMILARYNG ANTERO-LATERO-VERTICAL | Long Descr | Partial laryngectomy (hemilaryngectomy); antero-latero-vertical | 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 |
| 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). | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 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 | GW | Service not related to the hospice patient's terminal condition | RT | Right side (used to identify procedures performed on the right side of the body) |
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| Pre-1990 | Added | Code added. |
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