2025 CPT code 31781
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Respiratory System Surgery Feed
Excision of tracheal stenosis and anastomosis in the cervicothoracic region.
Modifiers may be applied based on the circumstances of the procedure (e.g., 51 for multiple procedures, 59 for distinct procedural service, 78 for unplanned return to the operating room).
Medical necessity for a 31781 is established when a patient presents with symptomatic tracheal stenosis causing significant respiratory compromise, impacting their ability to maintain adequate oxygenation and ventilation.Conservative management options (e.g., dilation) have failed or are inappropriate.
The surgeon is responsible for performing the entire procedure, including the incision, tracheal dissection, excision of the stenosis, tracheal anastomosis, hemostasis, and wound closure.Pre-operative preparation, anesthesia administration, and post-operative care are the responsibilities of the anesthesia team and other medical staff.
In simple words: The doctor removes a narrowed section of the windpipe in the neck and upper chest.Then, they reconnect the windpipe to restore breathing.
This procedure involves the excision of a narrowed area of the trachea located in the neck and upper chest (cervicothoracic region).Following excision, the remaining tracheal segments are joined (anastomosis) to restore the airway's patency.The procedure requires careful dissection to avoid damage to surrounding structures such as the thyroid gland, major neck vessels, and recurrent laryngeal nerves. The surgeon will open the tracheal lumen, excise the stenotic area,mobilize the larynx and tracheal segments, then perform the anastomosis with sutures. Hemostasis is achieved, and the wound is closed in layers.
Example 1: A patient presents with post-intubation tracheal stenosis in the cervicothoracic region causing significant dyspnea.The surgeon performs a 31781 to excise the stenotic segment and re-establish airway patency., A patient with a congenital tracheal stenosis affecting the cervicothoracic region undergoes a 31781 to alleviate respiratory distress and improve quality of life., A patient who had prior tracheal trauma experiences recurrent stenosis.The 31781 is performed to remove the scar tissue and restore the airway.
Preoperative imaging (e.g., CT scan, bronchoscopy) demonstrating the location and extent of the stenosis. Operative report detailing the procedure performed, including the length of the excised segment, the type of anastomosis, and any complications encountered. Postoperative imaging (e.g., chest x-ray) to assess for pneumothorax or other complications.Pathology report confirming the nature of the excised tissue.Patient's medical history, including any previous surgeries or conditions relevant to the stenosis.
** This code encompasses procedures involving both cervical and thoracic portions of the trachea.Careful consideration must be given to the extent of the stenosis to determine the appropriate code selection.The complexity of the procedure may vary, impacting the time required and the resources utilized.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- Payment Status: Active
- Modifier TC rule: Not applicable.This is a comprehensive surgical procedure.
- Specialties:Thoracic Surgery, Otolaryngology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center