Otolaryngology Coding Alert

Question: Which CPT code(s) should I use for an in-office tracheo-esophageal voice prosthesis change and for the supplies, an 8-mm voice prosthesis and laryngectomy tubes?

North Dakota Subscriber Answer: For the prosthesis evaluation and change, you should use 92597 (Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech). Use this code, rather than an E/M service, such as 99212-99215 (Office or other outpatient visit for the evaluation and management of an established patient ...). Code 92597 appropriately describes the work involved in evaluating the need for prosthesis change and for fitting or placing the device.
 
Whenever possible, you should use HCPCS supply codes. For the prosthesis, you should report L8509 (Tracheo-esophageal voice prosthesis, inserted by a licensed healthcare provider, any type). Use A7520 (Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride [PVC], silicone or equal, each) or A7521 (Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride [PVC], silicone or equal, each) depending on the type of laryngectomy tube. For payers that don't accept the alphanumeric codes, you should instead report 99070 (Supplies and materials [except spectacles], provided by the physician over and above those usually included with the office visit or other services rendered [list drugs, trays, supplies, or materials provided]) with a description of the supply.