Patient presents with clinical findings suggestive of tracheoesophageal fistula (TEF).  Symptoms include excessive salivation, choking, coughing, and cyanosis, particularly during feeding.  Respiratory distress, including tachypnea and possible aspiration pneumonia, may be observed.  Prenatal ultrasound findings may have indicated polyhydramnios.  Postnatal diagnosis is confirmed by inability to pass a nasogastric or orogastric tube into the stomach and often by chest radiograph demonstrating the tube coiled in the esophageal pouch.  Bronchoscopy and esophagoscopy may be performed to visualize the fistula and assess its type and location.  Differential diagnosis includes esophageal atresia, esophageal stenosis, and vascular ring.  Treatment plan includes maintaining airway patency, preventing aspiration, and providing nutritional support via intravenous fluids. Surgical repair of the tracheoesophageal fistula is the definitive treatment and is typically performed soon after diagnosis.  Associated anomalies, such as VACTERL association (vertebral anomalies, anal atresia, cardiac defects, tracheoesophageal fistula, renal anomalies, and limb abnormalities), should be evaluated for and managed appropriately.  Postoperative care involves monitoring for complications such as anastomotic leak, stricture, gastroesophageal reflux, and recurrent fistula.  Long-term follow-up includes assessing swallowing function, respiratory health, and nutritional status. ICD-10 code Q39.0, congenital tracheoesophageal fistula, is applicable. CPT codes for diagnostic and therapeutic procedures will vary depending on the specific procedures performed, including imaging, bronchoscopy, esophagoscopy, and surgical repair.