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Official Description

Tracheostoma revision; complex, with flap rotation

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 31614 refers to a complex revision of an existing tracheostoma, which is an opening created in the neck to facilitate breathing through the trachea. This revision is specifically indicated for cases where there is stenosis, or narrowing, of the stoma, which can occur due to scar tissue formation. In contrast to a simpler revision procedure, identified by CPT® Code 31613, which does not involve flap rotation, the complex revision entails more intricate surgical techniques. During this procedure, the physician isolates a segment of the trachea, typically spanning 2-3 tracheal rings, to access the affected area. The scar tissue contributing to the stenosis is excised to restore proper function. Following this, one or more skin flaps are developed from the surrounding skin and subcutaneous tissues. These flaps are then rotated and sutured into the stoma to ensure adequate coverage and support for the trachea, promoting healing and reducing the risk of future stenosis. This detailed approach is essential for patients with more severe complications related to their tracheostoma, ensuring a more effective and lasting solution to their breathing difficulties.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 31614 is indicated for patients experiencing stenosis of the tracheostoma. This condition may arise due to the formation of scar tissue, which can obstruct airflow and complicate the patient's ability to breathe effectively. The complex revision is necessary when simpler methods, such as those outlined in CPT® Code 31613, are insufficient to address the severity of the stenosis.

  • Stenosis of the Tracheostoma This condition involves the narrowing of the stoma, which can lead to breathing difficulties and requires surgical intervention to restore proper airflow.

2. Procedure

The procedure for CPT® Code 31614 involves several critical steps to ensure a successful revision of the tracheostoma.

  • Step 1: Isolation of the Trachea The surgeon begins by isolating a segment of the trachea, typically spanning 2-3 tracheal rings. This isolation is crucial for accessing the area affected by stenosis and allows for a clear view of the surgical site.
  • Step 2: Excision of Scar Tissue Once the trachea is isolated, the surgeon excises the scar tissue that is causing the stenosis. This step is vital to remove the obstruction and restore the normal diameter of the stoma.
  • Step 3: Development of Skin Flaps After excising the scar tissue, the surgeon develops one or more skin flaps from the surrounding skin and subcutaneous tissues. This involves making incisions to create the flaps, which will be used to cover the stoma.
  • Step 4: Suturing the Flap The skin flap is then sutured to the trachea, ensuring that it is securely positioned within the stoma. This step is essential for providing adequate coverage and support, promoting healing, and minimizing the risk of future stenosis.
  • Step 5: Extension of the Tracheal Incision In some cases, the incision in the trachea may be extended vertically to facilitate better access and ensure that the revision is comprehensive.

3. Post-Procedure

Post-procedure care following a complex tracheostoma revision includes monitoring for any signs of complications, such as infection or further stenosis. Patients may require follow-up visits to assess the healing process and ensure that the stoma is functioning properly. It is essential to provide appropriate wound care and to educate the patient on signs of complications that may necessitate immediate medical attention. Recovery time may vary depending on the individual patient's condition and the extent of the procedure performed.

Short Descr TRACHEOSTOMA REVJ COMPLEX
Medium Descr TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION
Long Descr Tracheostoma revision; complex, with flap rotation
Status Code Active Code
Global Days 090 - Major Surgery
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) 1 - Statutory 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 34 - Tracheostomy, temporary and permanent
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
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).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
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.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
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.)
GC This service has been performed in part by a resident under the direction of a teaching physician
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Pre-1990 Added Code added.
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