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Official Description

Tracheal puncture, percutaneous with transtracheal aspiration and/or injection

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

A percutaneous tracheal puncture, as described by CPT® Code 31612, is a medical procedure that involves creating a small opening in the trachea to facilitate transtracheal aspiration and/or injection. This procedure is typically indicated for patients who require access to the trachea for therapeutic purposes, such as the aspiration of fluid or the administration of medications directly into the trachea. The procedure begins with a small stab incision made over the trachea, specifically at the level of the cricoid cartilage, which is located in the neck. Following the incision, a needle or catheter is carefully advanced through the surrounding thyroid tissue and into the trachea itself. Once access to the trachea is achieved, the physician can aspirate any fluid present or inject medications or other pharmacological substances as needed. After the procedure is completed, the needle or catheter is withdrawn, and the stab incision is typically closed using sutures or an adhesive patch to promote healing and prevent complications. This procedure is essential in various clinical scenarios where direct access to the airway is necessary for effective treatment.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The percutaneous tracheal puncture procedure (CPT® Code 31612) is indicated for specific clinical situations where direct access to the trachea is required. The following conditions may warrant this procedure:

  • Respiratory Distress Patients experiencing severe respiratory distress may require transtracheal aspiration to remove obstructive secretions or fluids that are impeding airflow.
  • Medication Administration The procedure is indicated for the direct injection of medications or pharmacological substances into the trachea, particularly in cases where traditional routes of administration are ineffective.
  • Diagnostic Purposes Transtracheal aspiration may be performed to obtain samples for diagnostic testing, such as cultures or cytology, in patients with suspected infections or malignancies affecting the airway.

2. Procedure

The procedure for a percutaneous tracheal puncture involves several critical steps to ensure safety and effectiveness. The following outlines the procedural steps:

  • Step 1: Preparation The patient is positioned appropriately, and the area over the trachea is cleaned and sterilized to minimize the risk of infection. Local anesthesia may be administered to ensure patient comfort during the procedure.
  • Step 2: Incision A small stab incision is made over the trachea at the level of the cricoid cartilage. This incision is typically shallow and just enough to allow for the insertion of a needle or catheter.
  • Step 3: Insertion A needle or catheter is then carefully advanced through the thyroid tissue and into the trachea. The physician must ensure that the needle is correctly positioned within the trachea to avoid injury to surrounding structures.
  • Step 4: Aspiration or Injection Once the needle or catheter is in place, the physician can perform transtracheal aspiration to remove any fluid or secretions present in the airway. Alternatively, medications or other pharmacological substances can be injected directly into the trachea as indicated.
  • Step 5: Closure After the aspiration or injection is completed, the needle or catheter is withdrawn. The stab incision is then closed using sutures or an adhesive patch to promote healing and prevent complications.

3. Post-Procedure

Post-procedure care following a percutaneous tracheal puncture is essential to ensure proper healing and monitor for any potential complications. Patients are typically observed for any signs of respiratory distress, bleeding, or infection at the incision site. Instructions may include keeping the area clean and dry, monitoring for any unusual symptoms, and following up with the healthcare provider as directed. Recovery time may vary depending on the individual patient's condition and the complexity of the procedure performed.

Short Descr PERQ TRCHL PNXR TTRACH ASPIR
Medium Descr TRACHEAL PNXR PERQ W/TRANSTRACHEAL ASPIR&/NJX
Long Descr Tracheal puncture, percutaneous with transtracheal aspiration and/or injection
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5E - Ambulatory procedures - other
MUE 1
CCS Clinical Classification 42 - Other OR therapeutic procedures on respiratory system
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
GC This service has been performed in part by a resident under the direction of a teaching physician
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
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Notes
2025-01-01 Changed Short and Medium Descriptions changed.
Pre-1990 Added Code added.
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