How To Use CPT Code 31390

CPT 31390 describes the procedure of pharyngolaryngectomy with radical neck dissection, without reconstruction. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 31390?

CPT 31390 is used to describe the surgical procedure of pharyngolaryngectomy with radical neck dissection, without reconstruction. This code is used when the provider removes the pharynx and larynx in patients who have difficulty swallowing. It is important to note that this code does not include reconstruction.

2. Official Description

The official description of CPT code 31390 is: ‘Pharyngolaryngectomy, with radical neck dissection; without reconstruction.’

3. Procedure

1. The provider begins by performing a separate incision for tracheostomy to ensure the patient can breathe during the surgery.
2. A horizontal neck incision is made at the level of the thyroid cartilage to expose the larynx.
3. The provider raises the flaps from under the platysmal muscles, extending from the collarbone to the jaw, to further expose the larynx.
4. The provider removes all or part of the hyoid bone, which provides structural support to the tongue.
5. Lymph nodes are excised as part of the radical neck dissection.
6. The provider continues the radical neck dissection by removing the muscle present on the front of the neck, the internal jugular vein, and the submandibular gland.
7. The provider then removes the larynx and identifies the pharynx, which may require making an incision on the esophagus.
8. The pharynx is removed, and the incision is sutured.
9. It is important to note that reconstruction is not performed during this session.

4. Qualifying circumstances

CPT 31390 is performed on patients who have difficulty swallowing and require the removal of the pharynx and larynx. The procedure also includes radical neck dissection, which involves the excision of lymph nodes and other structures in the neck. It is important to note that this code does not include reconstruction.

5. When to use CPT code 31390

CPT code 31390 should be used when the provider performs a pharyngolaryngectomy with radical neck dissection, without reconstruction. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 31390, the provider must document the following information:

• Patient’s diagnosis and the need for pharyngolaryngectomy with radical neck dissection
• Details of the procedure performed, including the specific structures removed
• Date of the procedure
• Any additional relevant information or complications
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 31390, ensure that the procedure meets the specific criteria outlined in the code description. It is important to note that this code does not include reconstruction. Additionally, consider any additional guidelines or requirements from the payer when submitting the claim.

8. Historical information

CPT 31390 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates since its addition. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient with difficulty swallowing undergoes pharyngolaryngectomy with radical neck dissection, without reconstruction.
2. A provider performs pharyngolaryngectomy with radical neck dissection, without reconstruction, on a patient with a tumor in the larynx.
3. During the procedure, the provider removes the pharynx and larynx in a patient with advanced throat cancer.
4. A patient with recurrent laryngeal cancer undergoes pharyngolaryngectomy with radical neck dissection, without reconstruction.
5. A provider performs pharyngolaryngectomy with radical neck dissection, without reconstruction, on a patient with a history of radiation therapy for head and neck cancer.
6. A patient with dysphagia undergoes pharyngolaryngectomy with radical neck dissection, without reconstruction.
7. A provider removes the pharynx and larynx in a patient with a large tumor in the throat.
8. During the procedure, the provider performs radical neck dissection and removes lymph nodes in a patient with metastatic squamous cell carcinoma.
9. A patient with a recurrent tumor in the larynx undergoes pharyngolaryngectomy with radical neck dissection, without reconstruction.
10. A provider performs pharyngolaryngectomy with radical neck dissection, without reconstruction, on a patient with a history of tobacco and alcohol use.