Otolaryngology Coding Alert

Question: How should we code a TEP (tracheo-esophageal-pharyngeal) prosthesis change? Our otolaryngologist wants us to use either an unlisted-procedure code (31899, unlisted procedure, trachea, bronchi), 31611 (construction of tracheoesophageal fistula and subsequent insertion of an alaryngeal speech prosthesis) or 92597 (evaluation for use and/or fitting of voice prosthetic or augmentative ...). Which is correct?

North Carolina Subscriber

Answer: There is no code for this service in CPT 2002, although otolaryngologists have been pressing the AMA, which publishes CPT, to introduce one. Much like a trach change, the prosthesis change may be paid indirectly by reporting an E/M service code when appropriate.
 
Reader Questions and You Be the Coder answered by Randa Blackwell, a coding specialist with the department of otolaryngology at the University of Maryland in Baltimore; Susan Callaway, CPC, CCS-P, a coding and reimbursement specialist and educator in North Augusta, S.C.; Barbara Cobuzzi, MBA, CPC, CPC-H, an otolaryngology coding and reimbursement specialist and president of Cash Flow Solutions, a medical billing firm in Lakewood, N.J.; Lee Eisenberg, MD, an otolaryngologist in private practice in Englewood, N.J., and a member of CPT's editorial panel and executive committee; Ann Hughes, CPC, a practice coder with Mid-Vermont ENT in Rutland, Vt.; and Teresa Thompson, CPC, an otolaryngology coding and reimbursement specialist in Sequim, Wa.