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Tracheostomy, inner cannula

HCPCS code

Tracheostomy, Inner Cannula (A4623)

Name of the Procedure:

Common Name(s): Tracheostomy Cannula Change
Medical Term: Tracheostomy, Inner Cannula Replacement


A Tracheostomy inner cannula replacement involves changing the inner tube of a tracheostomy device. The inner cannula can be removed and cleaned or replaced to ensure that the airway remains clear and free of blockages.


This procedure maintains airway patency for patients with a tracheostomy. It helps prevent mucus build-up, infection, and blockage, ensuring proper ventilation and breathing.


  • Specific Symptoms: Excessive mucus production, difficulty breathing, blocked or clogged tracheostomy tube.
  • Patient Criteria: Patients with a tracheostomy who require regular maintenance to keep the airway clear.


  • Pre-procedure Instructions: The patient may be asked to sit or lie in a comfortable position. No fasting or major preparations are typically needed.
  • Diagnostic Tests: Routine monitoring of respiratory function may be performed, but no specific diagnostic tests are usually required.

Procedure Description

  1. Introduction: Explain the procedure to the patient to ensure they are comfortable and understand what will happen.
  2. Preparation: Wash and sanitize hands, and gather all necessary equipment, including sterile gloves, a new inner cannula, and cleaning supplies.
  3. Removal: Carefully remove the existing inner cannula.
  4. Cleaning: If reusing the inner cannula, clean it thoroughly per protocol. If a new cannula is being used, ensure it is sterile.
  5. Replacement: Insert the new or cleaned inner cannula into the tracheostomy tube.
  6. Secure: Ensure the cannula is securely in place.

This is typically performed using tools like sterile gloves, a clean or sterile inner cannula, and cleaning supplies. Anesthesia or sedation is not commonly required.


The procedure generally takes about 10 to 15 minutes.


This procedure is usually performed in a hospital, outpatient clinic, or home care setting.


Typically, the procedure is carried out by a nurse, respiratory therapist, or trained caregiver under the supervision of a healthcare provider.

Risks and Complications

  • Common Risks: Minor discomfort, temporary coughing.
  • Rare Risks: Infection, bleeding, improper fit leading to airway obstruction.


  • Expected Benefits: Improves airflow, reduces infection risk, ensures that the tracheostomy device functions properly.
  • Timeline: Benefits like improved breathing and comfort are usually immediate.


  • Post-Procedure Care: Monitor for signs of discomfort, infection, or airway obstruction. Keep the area clean and dry.
  • Recovery Time: Immediate. Patients can usually resume their normal activities right away.
  • Follow-Up: Regular tracheostomy care and follow-ups as per healthcare provider’s advice.


  • Other Options: Regular suctioning of the tracheostomy tube, using tracheostomy tubes with built-in cleaning features.
  • Pros and Cons: Alternatives may not adequately clear blockages or could be more invasive. Regular cannula change is often simpler and effective.

Patient Experience

  • What to Expect: Mild discomfort or coughing during the procedure.
  • Pain Management: Usually not painful, but discomfort can be managed with gentle handling and reassurance.

This markdown provides an easy-to-read, concise guide for patients and healthcare providers regarding the Tracheostomy, Inner Cannula procedure (A4623).

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