Summary & Overview
CPT 31380: Anterovertical Hemilaryngectomy (Partial Laryngectomy)
CPT code 31380 denotes an anterovertical hemilaryngectomy — a partial laryngectomy in which the anterior commissure and a portion of a vocal cord are removed. This operative code captures a clinically significant head and neck surgical service used to treat localized laryngeal pathology, including select malignant and pre-malignant lesions. As a relatively specialized surgical procedure, accurate coding affects hospital and surgeon claims, care setting decisions, and national activity tracking for laryngeal surgeries.
Key payers commonly involved in coverage and reimbursement for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find national benchmarks for utilization and reimbursement patterns, clinical context for when the procedure is used, and relevant coding considerations that influence claim adjudication. The analysis highlights typical sites of service, expected billing patterns for a partial laryngectomy, and policy-relevant issues such as documentation elements that support medical necessity.
This summary is written for a national audience and provides a concise reference for clinicians, billing professionals, and policy analysts seeking to understand the clinical intent and billing implications of CPT code 31380. Data not available in the input is noted where applicable in the full publication.
Billing Code Overview
CPT code 31380 describes a surgical procedure in which the provider removes part of the larynx (voice box). In an anterovertical hemilaryngectomy, the provider removes the anterior commissure, where the vocal cords meet, and typically excises a portion of a vocal cord as well.
-
Service type: Surgical resection of laryngeal structures (partial laryngectomy)
-
Typical site of service: Hospital operating room or ambulatory surgical center, depending on clinical complexity and patient status
Clinical & Coding Specifications
Clinical Context
A 62-year-old male smoker presents with months of progressive hoarseness and a small, biopsy-proven squamous cell carcinoma localized to the anterior portion of one true vocal cord involving the anterior commissure. After multidisciplinary tumor board review, the otolaryngologist schedules an anterovertical hemilaryngectomy to remove the anterior commissure and the involved portion of the vocal cord with intent for oncologic resection while preserving laryngeal function when feasible. The typical workflow includes preoperative evaluation (history, physical, airway assessment), laryngoscopy with biopsy and imaging (contrast CT or MRI of the neck), informed consent, pre-anesthesia assessment, and same-day operative procedure under general anesthesia in an operating room. Intraoperative steps include direct laryngoscopy, endotracheal or specialized tube placement, exposure of the larynx, resection of the anterior commissure and involved cord tissue, hemostasis, and possible placement of temporary tracheostomy if airway compromise is anticipated. Postoperative care involves airway monitoring in PACU or inpatient stay, pain control, voice rest, swallow assessment, speech pathology for voice rehabilitation, surveillance laryngoscopy, and coordination with oncology for adjuvant therapy if pathology indicates positive margins or deeper invasion.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the work, time, technical difficulty, or risk of the hemilaryngectomy is substantially greater than typical due to extensive fibrosis, prior radiation, or complex reconstruction. |