# Tracheoesophageal fistula with insertion of speech prosthesis



## nsteinhauser (Sep 23, 2016)

The lay description for CPT code 31611 reads:  "The physician constructs a tracheal esophageal fistula for vocalization. The physician makes a horizontal neck incision and dissects the tissues between the tracheostoma and the esophagus. The esophagus is incised and a laryngeal speech prosthesis is inserted between the esophagus and the trachea, creating a fistula. The prosthesis, called a voice button or a Blom-Singer prosthesis, is a one-way valve enabling the patient to phonate. The physician closes the incision around the prosthesis." 
Our surgeon used a Provox needle to do a TE puncture, dilated and then slid the voice prosthesis down into place over the previously passed guide wire.  There is no 'neck incision,' per se.   Is 31611 the appropriate code?  I'm billing for the facility and am not a DME provider.   
Thank you in advance for any guidance!


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