CPT 31614 Tracheostoma Revision Benchmarks | OpenPayer

Summary & Overview

CPT 31614: Revision of Tracheostoma with Flap Rotation

CPT code 31614 represents a surgical revision of a tracheostoma involving flap rotation to revise the opening into the trachea. This code captures procedures intended to restore or improve tracheostoma function and anatomic integrity, and it is relevant for surgical specialties managing airway stomas, including otolaryngology and thoracic surgery. Nationally, accurate use of this code supports appropriate surgical reporting, quality monitoring, and payment for airway reconstruction services. Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for tracheostoma revision, benchmarks for coding and reporting, payer coverage considerations, and common billing modifiers used alongside this code. The publication also summarizes typical sites of service and scenarios where this code is applicable. Data not available in the input is noted where applicable for elements such as associated taxonomies, specific ICD-10 diagnoses, and related procedure codes.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare31614CPTtracheostoma revisiontracheal surgeryotolaryngologyambulatory surgeryoperating roomairway reconstruction

Billing Code Overview

CPT code 31614 describes a surgical revision with flap rotation of the opening, or stoma, into the trachea (windpipe). This procedure entails altering and rotating tissue flaps to revise the tracheostoma and improve function, patency, or fit.

Service type: Surgical revision of a tracheostoma with flap rotation
Typical site of service: Hospital operating room or ambulatory surgery center (inpatient or outpatient surgical settings)

Clinical & Coding Specifications

Clinical Context

A 68-year-old patient with a permanent tracheostomy presents with progressive peristomal breakdown, stomal stenosis, and recurrent tracheostomy-related granulation tissue causing difficulty with cannula changes and intermittent respiratory distress. The otolaryngology team evaluates the airway, performs preoperative airway endoscopy, and determines that the stoma requires revision with flap rotation to restore a functional, watertight stoma and prevent recurrent obstruction. The patient is taken to the operating room under general anesthesia. The procedure includes excision of scarred or stenotic stomal tissue, mobilization of local skin and subcutaneous flaps, rotation and inset of the flap to reconstruct the stoma, hemostasis, and placement of appropriate tracheostomy tube. Postoperative care includes airway observation in a PACU or step-down unit, pain control, suctioning as needed, wound care instructions, and follow-up with the surgical team for stoma assessment and possible dilations.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required is substantially greater than typical (extensive scar tissue, complex flap dissection).
`52`	Reduced services

CPT 31612: Transtracheal Aspiration or Injection

CPT-31601-TRACHEOSTOMY-INFANTS-PLANNED

CPT 31601: Planned Tracheostomy in Patients Younger Than Two Years

CPT-31611-TRACHEOESOPHAGEAL-FISTULA-WITH-SPEECH-PROSTHESIS

CPT 31611: Tracheoesophageal Fistula Creation with Speech Prosthesis

CPT-31610-PERMANENT-TRACHEOSTOMY-SKIN-FLAPS

CPT 31610: Permanent Tracheostomy Using Skin Flaps

CPT-31600-PLANNED-TRACHEOSTOMY-SURGICAL-AIRWAY-PROCEDURE

CPT 31600: Planned Tracheostomy, Surgical Airway Procedure

CPT-31603-EMERGENCY-TRANSTRACHEAL-TRACHEOSTOMY

CPT 31603: Emergency Transtracheal Tracheostomy

CPT-31613-TRACHEOSTOMY-STOMA-REVISION-WITHOUT-FLAP-ROTATION

CPT 31613: Revision of Tracheostomy Stoma Without Flap Rotation

CPT-31605-EMERGENCY-TRACHEOSTOMY-CRICOTHYROID-MEMBRANE

CPT 31605: Emergency Tracheostomy via Cricothyroid Membrane

Taxonomy Code	Specialty	Notes
207L00000X	Otolaryngology (ENT)	Most common specialty performing tracheostomy and stoma revisions.
208000000X	General Surgery	General surgeons in trauma/critical care settings may perform tracheostomy revisions.
2084P0800X	Thoracic Surgery	Thoracic surgeons manage complex airway and tracheal reconstructions.
208D00000X	Plastic Surgery	Plastic surgeons may be involved when complex flap design or extensive skin reconstruction is required.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.	Data not available in the input.	Data not available in the input.
`J95.1`	Tracheostomy stenosis	Common indication for stoma revision to relieve airway obstruction.
`T81.89XA`	Other complications of procedures, initial encounter	May be used when revision is needed for postoperative complications such as wound breakdown or infection.
`L89.309`	Pressure ulcer of unspecified site, stage 3	Peristomal pressure injury contributing to stoma breakdown requiring revision.
`J96.00`	Acute respiratory failure, unspecified whether with hypoxia or hypercapnia	May be present preoperatively in patients with compromised airway requiring urgent revision.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`31600`	Tracheostomy, planned (separate procedure); open (separate procedure)	May be performed initially if a new tracheostomy is required prior to or instead of revision.
`31603`	Tracheostomy, emergency; primary	Performed in emergent airway situations; may precede a staged revision when stabilization was first required.
`31500`	Intubation, endotracheal, emergency procedure	Used intraoperatively or preoperatively for airway control before tracheostomy revision.
`31750`	Closure of tracheostomy, including surgical closure, when applicable	Performed when a tracheostomy is no longer required and the stoma is surgically closed rather than revised.
`21253`	Repair of full thickness defect of cheek and labial mucosa with local flap; single or multiple	Represents reconstructive flap techniques that may be analogous when complex local flap work is required at the stoma site.

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