2025 CPT code 31360
(Active) Effective Date: N/A Revision Date: N/A Surgery - Excision Procedures on the Larynx Surgery Feed
Total laryngectomy without radical neck dissection.
Modifiers may be applicable depending on the circumstances of the procedure. Consult the most current CPT coding guidelines for modifier rules and appropriate application.
Medical necessity for a total laryngectomy is established by the presence of laryngeal cancer that cannot be effectively treated with less invasive methods (e.g., radiation therapy, chemotherapy). The absence of clinically positive lymph nodes in the neck would support the decision to not perform a neck dissection, thereby justifying the use of CPT code 31360.
The surgeon is responsible for all aspects of the procedure, including pre-operative preparation, tracheostomy placement (prior to laryngectomy),laryngeal dissection and excision, and layered wound closure.The anesthesiologist is responsible for maintaining patient anesthesia.
In simple words: The doctor removes the entire voice box. This surgery does not include removing nearby lymph nodes or other tissues.
This CPT code encompasses the surgical removal of the entire larynx (voice box) without the additional resection of lymph nodes or surrounding tissues characteristic of a radical neck dissection.The procedure involves a meticulous dissection and excision of the larynx, often including a portion or all of the hyoid bone.A tracheostomy is typically performed prior to laryngectomy to ensure an airway during the procedure.Post-operative wound closure is layered.
Example 1: A 65-year-old male presents with a T3N0M0 laryngeal squamous cell carcinoma.The surgeon performs a total laryngectomy (31360) without neck dissection due to the absence of palpable lymph nodes., A 72-year-old female with a history of smoking presents with recurrent laryngeal cancer after previous radiotherapy.A total laryngectomy (31360) is performed without neck dissection as imaging studies revealed no regional lymph node involvement., A 58-year-old male patient diagnosed with early-stage laryngeal cancer opts for a total laryngectomy (31360) to avoid the more extensive surgical approach associated with a neck dissection. The surgeon determines neck dissection is not medically necessary given the early stage of the cancer and lack of lymph node involvement.
Complete history and physical examination, pre-operative imaging (e.g., CT scan, MRI), pathology report confirming the diagnosis of laryngeal cancer, operative report detailing the surgical technique, including confirmation that a radical neck dissection was not performed, and post-operative progress notes.
** The information provided is limited.For comprehensive coding guidance, consult the AMA CPT manual, payer-specific guidelines, and NCCI edits.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: This information is not available in the provided text.RVUs vary based on geographic location and other factors.
- Global Days: The global period for this procedure is not specified in the provided data and would require reference to additional payer-specific guidelines or fee schedules.
- Payment Status: Active
- Modifier TC rule: This information is not available from the provided data. It would require additional research.
- Fee Schedule: This information is not available in the provided text and would require additional research based on location and payer.
- Specialties:Otolaryngology, Head and Neck Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center