Summary & Overview
CPT 31367: Subtotal (Supraglottic) Laryngectomy
CPT code 31367 represents a subtotal (partial or extended near–total) laryngectomy removing the laryngeal structures above the vocal cords without radical neck dissection. This surgical code captures a distinct head and neck operative service commonly performed by otolaryngologists and head and neck surgeons for malignant and select benign supraglottic conditions. Nationally, accurate reporting of this code matters for surgical quality measurement, resource allocation, and appropriate payment for complex airway and oncologic procedures.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides benchmarking context and payer coverage considerations relevant to hospitals and surgical centers, noting common clinical settings and the service line for billing teams.
Readers will learn the clinical scope of CPT code 31367, expected sites of service, common payer coverage landscape, and what to expect in related coding practice. The report highlights how this code fits into head and neck surgical service lines, summarizes payer inclusion, and outlines areas where readers should consult clinical documentation and payer-specific policy language. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 31367 describes a subtotal (partial or extended near–total) laryngectomy, a surgical procedure removing the portion of the larynx (voice box) above the vocal cords without performing a radical neck dissection. The service involves excision of supraglottic laryngeal tissue while preserving structures below the vocal cords.
Service Type: Surgical — Head and Neck (Otolaryngology)
Typical Site of Service: Inpatient hospital or ambulatory surgical center, depending on clinical complexity and perioperative needs. Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 62-year-old male with a history of heavy tobacco and alcohol use who presents with progressive hoarseness, dysphagia, and an enlarging supraglottic mass confirmed on laryngoscopy and imaging. Biopsy returns squamous cell carcinoma confined to the supraglottic larynx without radiographic evidence of distant metastasis or extensive nodal disease. After multidisciplinary tumor board review, the otolaryngology–head and neck surgery team recommends a subtotal (partial or extended near–total) laryngectomy to remove the supraglottic laryngeal tumor above the vocal cords while preserving the laryngeal framework and avoiding a radical neck dissection.
The clinical workflow includes preoperative staging (contrast CT/MRI of neck and chest), anesthesiology evaluation, informed consent discussing airway and swallowing outcomes, intraoperative direct laryngoscopy and tumor extirpation via open partial laryngectomy, potential temporary tracheostomy for airway protection, intraoperative frozen sections as needed, and postoperative ICU monitoring with speech–language pathology involvement for swallow assessment and rehabilitation. Adjuvant radiation or chemoradiation is planned based on final pathology and nodal status.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the operative report documents substantially greater work, time, or complexity than typical for a subtotal laryngectomy. |