# Placement of Provox voice prosthesis



## Chanda Wells (Dec 14, 2010)

Hello,

I am at the facility where a Provox Acti Valve voice prosthesis will be placed.  This will be for a Medicare patient.  I am having trouble locating a HCPCS/CPT or T code.  Does anyone have any experience in this department?  He is going to have to have a new one inserted every 4 weeks so we will be coding for this numerous times.

Thank you,

Chanda Arscott, CPC-H, CPC-P


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## suec (Jun 4, 2020)

Did you get an answer on how to code the replacement?


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## jackjones62 (Jun 5, 2020)

Good Morning, Unfortunately there have been no updated CPT Codes to accommodate all the new technologies, but regardless of the type of voice prosthesis being used, Blom-Singer or this Provox it is being inserted the same way thru a tracheoesophageal fistula or TEP.  As per the AAPC Coder, CPT 31611 is used for the insertion even after the initial establishment of the fistula, any subsequent insertions will be coded the same, CPT 31611.

*31611 - Coding*
Code Descriptor - Construction of tracheoesophageal fistula and subsequent insertion of a laryngeal speech prosthesis (eg, voice button, Blom-Singer prosthesis)

_*Lay Terms*_
The provider surgically creates a fistula between the trachea, or wind pipe, and the esophagus, or food pipe. *This code also includes subsequent insertion of a speech prosthesis in the passage created.

Clinical Responsibility*
When the patient is appropriately prepped and anesthetized, the provider makes an incision on the neck to access the trachea and esophagus. He divides the tissues between the tracheal opening and esophagus, incising the esophagus. The provider thereby creates a fistula, or opening, between the trachea and the esophagus. He then inserts a speech prosthesis in the passage created. The provider closes the incision around the prosthesis with sutures. A Blom–Singer prosthesis is a device that helps the patient to produce sounds or talk. This procedure is performed in patients with paralyzed laryngeal structures.
*Terminology*
Fistula: A passage between a hollow organ and the body surface, or between two hollow organs; may be surgically created or result from a natural process.

Hope this helps! 

Jennifer
Coding Analyst
(27 yrs. ENT)


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## suec (Jun 22, 2020)

Thank You!


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