Summary & Overview
CPT 31368: Supraglottic Laryngectomy with Radical Neck Dissection
CPT code 31368 denotes a supraglottic laryngectomy performed with a radical neck dissection — a major head and neck oncologic surgery that combines removal of the upper larynx with comprehensive lymphadenectomy. Nationally, this code captures high-complexity surgical management of supraglottic malignancies and is relevant to hospital inpatient utilization, surgical quality measurement, and reimbursement for complex otolaryngology procedures.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical site-of-service and service-type characterization, and coverage-relevant considerations. The publication outlines benchmarking elements and policy-relevant factors that affect payment and utilization for major head and neck surgery. It is intended to inform coding staff, clinical program managers, and policy analysts about the clinical identity of the code, payer coverage landscape, and where to look for more detailed claims- or policy-level information.
Data not available in the input for specific modifiers, associated taxonomies, ICD-10 diagnoses, related codes, or service-line detail.
Billing Code Overview
CPT code 31368 represents a supraglottic laryngectomy with radical neck dissection, a surgical procedure that removes the upper portion of the larynx (voice box) in conjunction with removal of regional lymph nodes and surrounding tissues. The procedure is performed by otolaryngology–head and neck surgeons for management of tumors or advanced disease involving supraglottic structures.
Service type: Surgical — major head and neck oncologic surgery
Typical site of service: Inpatient hospital or ambulatory surgical center with postoperative inpatient care as needed
Clinical & Coding Specifications
Clinical Context
A 62-year-old male with a history of heavy tobacco use presents with progressive hoarseness, dysphagia, and a palpable neck mass. Biopsy of a supraglottic lesion confirms squamous cell carcinoma of the supraglottis. Preoperative imaging shows a primary tumor confined to the supraglottic larynx with ipsilateral cervical lymphadenopathy. The multidisciplinary team recommends curative surgical management consisting of 31368 (supraglottic laryngectomy) with concurrent radical neck dissection to achieve oncologic control and regional lymph node clearance. The clinical workflow includes preoperative staging and anesthesia assessment, intraoperative lesion resection with margin assessment and concurrent selective or radical neck dissection, possible intraoperative consultation with pathology for frozen section, postoperative airway monitoring (often in an intensive care or step-down unit), swallow evaluation, enteral nutrition planning, speech and language pathology for voice and swallow rehabilitation, and scheduled outpatient follow-up for wound and oncologic surveillance.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the work, time, or technical difficulty significantly exceeds usual for 31368 (document specific reasons). |