CPT 31825 Tracheostomy Closure Reimbursement | OpenPayer

Summary & Overview

CPT 31825: Tracheostomy or Tracheocutaneous Fistula Closure, Plastic Repair

CPT code 31825 identifies surgical closure of a tracheostomy or tracheocutaneous fistula with plastic repair. This procedure addresses a persistent opening between the trachea and skin that can persist after decannulation or as a complication of tracheostomy, restoring airway integrity and neck contour. Nationally, the code matters for surgical specialties managing airway reconstruction and for payers evaluating coverage and payment for medically necessary closure procedures.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. The publication provides a concise reference for clinicians and billing staff on code intent, typical service settings, and common modifiers used with operative procedures.

Readers will find: a clinical context for when CPT code 31825 is used; the expected service type and typical sites of service; and practical information for aligning documentation with coding. Where payer-specific policies and benchmark data would apply, this summary indicates the relevant payers covered in the analysis. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare31825CPTtracheostomy closureairway surgeryhead and neck surgeryambulatory surgical centeroperative codingsurgical procedure

Billing Code Overview

CPT code 31825 describes the surgical closure of a tracheostomy or tracheocutaneous fistula. The procedure involves excision of the tract and plastic repair to close the opening between the trachea and the skin when a tracheostomy fails to heal or a persistent fistula remains.

Service type: Surgical procedure — tracheostomy closure with plastic repair

Typical site of service: Hospital operating room or ambulatory surgical center

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult who previously underwent tracheostomy for prolonged ventilatory support and now presents months later with a persistent tracheocutaneous fistula and depressed scar. The patient reports air leak around the stoma, local irritation, and occasional mucous discharge; the fistula fails to close after decannulation. Preoperative assessment includes airway evaluation, review of prior operative reports, assessment for active infection, and discussion of anesthesia risks. The surgical workflow includes marking the fistula, administration of general anesthesia (or monitored anesthesia care if indicated), excision of the epithelialized tract, layered closure of the tracheal wall and skin with plastic repair techniques to restore cosmesis and prevent airway compromise, and postoperative monitoring for airway patency, subcutaneous emphysema, and wound infection. Typical post-op care includes short inpatient observation or same-day discharge depending on airway stability, instructions on wound care, and follow-up for suture removal and scar assessment.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required is substantially greater than typical for closure of tracheostomy (eg, extensive scar revision, complex flap repair).
`23`

CPT 31785: Excision of Cervical Tracheal Tumor

CPT-31786-THORACIC-TRACHEAL-TUMOR-EXCISION

CPT 31786: Excision of Thoracic Tracheal Tumor

CPT-31820-TRACHEOSTOMY-CLOSURE-TRACHEOCUTANEOUS-FISTULA-CLOSURE

CPT 31820: Tracheostomy or Tracheocutaneous Fistula Closure

CPT-31780-TRACHEAL-RESECTION-PRIMARY-ANASTOMOSIS

CPT 31780: Tracheal Resection with Primary Anastomosis

CPT-31775-BRONCHIAL-STENOSIS-REPAIR-MUCOSAL-FLAP-RECONSTRUCTION

CPT 31775: Bronchial Stenosis Repair with Mucosal Flap Reconstruction

CPT-31766-CARINA-RECONSTRUCTION-AFTER-TUMOR-RESECTION

CPT 31766: Carina Reconstruction After Tumor Resection

CPT-31750-CERVICAL-TRACHEA-REPAIR-OPEN-AIRWAY-RECONSTRUCTION

CPT 31750: Repair of Cervical Trachea for Open Airway Reconstruction

CPT-31755-TRACHEA-PHARYNX-CONNECTION-SURGICAL-RECONSTRUCTION

CPT 31755: Trachea-to-Pharynx Surgical Connection

CPT-31770-AIRWAY-REPAIR-WITH-GRAFT-OR-PATCH

CPT 31770: Repair of Airway with Graft or Patch

CPT-31760-INTRATHORACIC-TRACHEA-REPAIR-OPEN-AIRWAY-RECONSTRUCTION

CPT 31760: Intrathoracic Trachea Repair, Open Airway Reconstruction

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Taxonomy Code	Specialty	Notes
207L00000X	Otolaryngology (ENT)	Common specialty performing tracheostomy closure and airway-related plastic repair.
207P00000X	Plastic Surgery	Performs complex scar revision and layered closure for optimal cosmesis.
2080P0206X	General Surgery	May perform closure when originally placed by general surgeons or in trauma settings.
208000000X	Thoracic Surgery	May be involved if deeper tracheal repair or airway reconstruction is required.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`J95.2`	Tracheostomy complication	Directly indicates complication of tracheostomy such as persistent tracheocutaneous fistula requiring surgical closure.
`T81.4XXA`	Infection following a procedure, initial encounter	Relevant when infection of the stoma or tract necessitates debridement and delayed closure.
`K11.3`	Fistula of salivary gland and ducts	Included when nearby fistula processes are considered in differential for neck fistula (less common).
`S12.9`	Unspecified fracture of neck, initial encounter	Relevant in trauma patients whose tracheostomy and subsequent fistula closure occur in context of neck trauma.
`Z98.890`	Other specified postprocedural states	Used to indicate a history of tracheostomy or other airway procedures when planning closure.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`31600`	Tracheostomy, planned (separate procedure); with tracheotomy (separate procedure)	Performed prior to the need for closure; historical procedure that may appear in the chart.
`31500`	Intubation, emergency, using direct laryngoscopy, without endotracheal tube exchange	May be used perioperatively if emergent airway management is required.
`31575`	Endoscopic, transnasal or transoral, tracheal dilation; with or without tracheal stent placement	May be performed for concurrent tracheal stenosis before or after closure.
`13132`	Repair, complex, forehead, temple, head and/or neck; 1.1 cm to 2.5 cm	Example complex repair code for soft tissue reconstruction in the neck region if significant scar revision is required along with closure.
`11043`	Debridement, muscle and/or fascia (eg, for infected or nonhealing fistula tract)	May be performed if there is infected or nonviable tissue associated with the fistula prior to definitive closure.

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