Otolaryngology Coding Alert

Answer: Placement of the voice prosthesis is included in the charge for the original surgical procedure (31611, construction of tracheoesophageal fistula and subsequent insertion of an alaryngeal speech prosthesis [e.g., voice button, Blom-Singer prosthesis).
 
Use 92597 (evaluation for use and/or fitting of voice prosthetic or augmentative/alternative communication device to supplement oral speech) when replacing the voice prosthesis.
 
The prosthesis is billed to your durable medical equipment regional carrier (DMERC) and not your local Part B carrier. HCPCS 2002 includes the following new codes for tracheoesophageal voice prosthesis: L8507 (tracheo-esophageal voice prosthesis, patient inserted, any type, each) and L8509 (tracheo-esophageal voice prosthesis, inserted by a licensed healthcare provider, any type).
 
Note: Until 2002, different DMERC regions required either an unlisted code or codes that did not accurately describe the prosthesis.
 
Since the patient can purchase and insert the device described in L8507 on his or her own, practices typically bill L8509. Use L8505 (artificial larynx replacement battery/accessory, any type) for patients who bring their own prosthesis for replacement.