© Copyright 2025 American Medical Association. All rights reserved.
Cricotracheal resection is a surgical procedure aimed at removing a narrowed or scarred section of the airway located just below the larynx. This procedure is essential for restoring normal airflow by reattaching the larynx to healthy tracheal tissue. The narrowing or scarring of the trachea can occur due to various factors, including injury sustained during intubation or tracheostomy, the presence of a tracheal tumor or abnormal tissue growth, inflammatory diseases, or radiation therapy directed at the chest or neck. During the procedure, an endotracheal tube is inserted to deliver anesthesia and ensure that the airway remains open throughout the surgery. The surgical approach typically involves making a horizontal incision along the base of the neck, commonly referred to as the standard low collar line. This incision allows for the development of mucosal flaps in the subplatysmal plane, which exposes the airway from the hyoid bone at the top to the manubrium at the bottom. The procedure requires careful retraction of the strap muscles and division of the thyroid isthmus in the midline to gain access to the trachea. The surgeon identifies the distal end of the stenosis and mobilizes the trachea circumferentially to the inferior border of the cricoid cartilage. Blunt dissection along the anterior wall of the trachea to the level of the aortic arch or carina facilitates further mobilization and reduces tension during the anastomosis. Throughout the procedure, it is crucial to preserve the vascular supply with minimal lateral dissection. The cricoid muscle is then reflected superiorly, and the perichondrium on both the upper and lower borders of the cricoid cartilage is incised to allow for the excision of the anterior segment. The dissection continues carefully along the inner aspect of the cricoid cartilage, ensuring that the laryngeal nerves are preserved. The stenosis is excised from within the cricoid lumen while maintaining the integrity of the outer perichondrium of the cricoid plate. The cricoid plate is thinned posteriorly, and the distal and proximal margins of the stenosis are identified for en bloc resection. Finally, the transected normal trachea is telescoped into the posterior cricoid plate and sutured to the mucosal flap and thyroid cartilage. To maintain a patent airway postoperatively, a T-tube may be inserted into the trachea, and the incision is closed in layers. Chin to chest fixation sutures may also be placed to prevent neck flexion during the initial week of recovery.
© Copyright 2025 Coding Ahead. All rights reserved.
The cricotracheal resection procedure is indicated for patients experiencing significant airway obstruction due to various conditions affecting the trachea. These indications include:
The cricotracheal resection involves several critical procedural steps to ensure successful removal of the stenotic segment and reattachment of the larynx to healthy tracheal tissue. The steps include:
After the cricotracheal resection, patients can expect specific post-procedure care and considerations. The insertion of a T-tube into the trachea is a common practice to ensure that the airway remains patent during the recovery phase. Patients will be monitored closely for any signs of complications, such as airway obstruction or infection. The surgical site will be assessed for proper healing, and the chin to chest fixation sutures may be maintained to prevent neck flexion, which could jeopardize the anastomosis. Recovery may involve a period of restricted activity, and patients will receive guidance on respiratory care and follow-up appointments to evaluate the success of the procedure and airway function.
| Short Descr | CRICOTRACHEAL RESECTION | Medium Descr | CRICOTRACHEAL RESECTION | Long Descr | Cricotracheal resection | 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) | 0 - Payment restriction for assistants at surgery applies 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 | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 |
| 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). | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 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 |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2017-01-01 | Added | Added |
Get instant expert-level medical coding assistance.