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An arytenoidectomy or arytenoidopexy is a surgical procedure that involves the external approach to the arytenoid cartilage, which is a critical component of the larynx. The arytenoid cartilage plays a significant role in the function of the vocal cords and the airway. Arytenoidectomy specifically refers to the surgical removal or laser vaporization of the arytenoid cartilage, while arytenoidopexy involves the fixation or suspension of this cartilage. These procedures are primarily indicated for patients suffering from bilateral vocal cord paralysis, a condition that can severely compromise the airway and hinder normal breathing. By performing these surgeries, the surgeon aims to enhance airway patency and improve respiratory function. The procedure begins with a horizontal incision made over the larynx, allowing access to the underlying structures. The careful dissection and manipulation of the laryngeal tissues are essential to successfully execute either the excision or fixation of the arytenoid cartilage, ultimately leading to improved airway management for the patient.
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The arytenoidectomy or arytenoidopexy is indicated for specific conditions that affect the airway and vocal cord function. The primary indications for performing this procedure include:
The procedure for arytenoidectomy or arytenoidopexy involves several critical steps to ensure successful access and manipulation of the arytenoid cartilage. The steps are as follows:
Post-procedure care following an arytenoidectomy or arytenoidopexy involves monitoring the patient for any complications and ensuring proper recovery. Patients may require observation for airway patency and management of any discomfort. The presence of a drain in the neck will be monitored, and it may be removed once the output is minimal. Follow-up appointments are essential to assess the healing process and the effectiveness of the procedure in improving airway function. Patients may also receive instructions regarding voice rest and gradual resumption of normal activities as they recover.
| Short Descr | REVISION OF LARYNX | Medium Descr | ARYTENOIDECTOMY/ARYTENOIDOPEXY XTRNL APPROACH | Long Descr | Arytenoidectomy or arytenoidopexy, external approach | 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) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | 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). | 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.) | 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 | GW | Service not related to the hospice patient's terminal condition | LT | Left side (used to identify procedures performed on the left side of the body) | 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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