HCPCS CODING REFERENCE CHART

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HCPCS CODING REFERENCE CHART

HCPCS

CODES

HCPCS CODE DESCRIPTIONS

COMMENTS

L7510 Repair of prosthetic device, repair or replace minor parts This code covers replacement parts for bone anchored hearing aid that are not otherwise classified by another HCPCS code; bill Part B L7520 Repair prosthetic device, labor component, per 15 minutes This code covers the labor for repair of cochlear implant or bone anchored hearing aid; bill Part B L8614 Cochlear device, includes all internal and external components This code represents the acquisition/device cost of an initial cochlear implant, speech processor and accessory kit; billed by implanting facility L8615 Headset/headpiece for use with cochlear implant device,

replacement This is to be used when providing a replacement headset/headpiece or any component of those items to a cochlear implant recipient; this is not to be used to bill an initial device fitting; bill Part B L8616 Microphone for use with cochlear implant device, replacement This is to be used when providing a

replacement microphone or any component of those items to a cochlear implant recipient; this is not to be used to bill an initial device fitting; bill Part B L8617 Transmitting coil for use with cochlear implant device,

replacement This is to be used when providing a replacement transmitting coil or any component of those items to a cochlear implant recipient; this is not to be used to bill an initial device fitting; bill Part B L8618 Transmitter cable for use with cochlear implant device,

replacement This is to be used when providing a replacement transmitter cable to a cochlear implant recipient; this is not to be used to bill an initial device fitting; bill Part B

L8619 Cochlear implant, external speech processor and controller, integrated system, replacement This code covers the acquisition/device cost of a replacement or upgraded i n t e g r a t e d speech processor/controller for use with a cochlear implant; bill Part B L8621 Zinc air battery for use with cochlear implant device,

replacement, each

This code is used to bill for replacement batteries for a cochlear implant; this is billed per battery so it must be multiplied; bill Part B

L8622 Alkaline battery for use with cochlear implant device, any size, replacement, each This code is used to bill for replacement batteries for a cochlear implant; this is billed per battery so it must be multiplied; bill Part B L8623 Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each This code is used to bill for replacement batteries for a cochlear implant; this is billed per battery so it must be

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multiplied; bill Part B L8624 Lithium ion battery for use with cochlear implant device speech processor, ear level, replacement, each This code is used to bill for replacement batteries for a cochlear implant; this is billed per battery so it must be multiplied; bill Part B L8627 Cochlear implant, external speech processor, component, replacement This code covers the acquisition/device cost of a replacement or upgraded s p e e c h p r o c e s s o r for use with a cochlear implant; bill Part B L8628 Cochlear implant, external controller component, replacement This code covers the acquisition/device cost of a replacement or upgraded c o n t r o l l e r for use with a cochlear implant; bill Part B L8629 Transmitting coil and cable, integrated for use with cochlear implant device, replacement This is to be used when providing a replacement an integrated transmitting coil and cable to a cochlear implant recipient; this is not to be used to bill an initial device fitting; bill Part B

L8690 Auditory osseointegrated device, includes all internal and external components

This code is used to bill a bone anchored hearing aid system; billed by implanting facility

L8691 Auditory osseointegrated device, external sound processor, replacement

This code is used to bill a replacement, bone anchored hearing aid, external sound processor; bill Part B L8692 Auditory osseointegrated device, external sound processor, used without osseointegration, body worn, includes headband or other mean of external attachment This code is for a bone anchored hearing aid that is not implanted but rather worn with a soft band; bill Part B L8693 Auditory osseointegrated device abutment, any length, replacement only This is a code for a replacement abutment; this should be billed by implanting facility L9900 Orthotic and prosthetic supply, accessory and/or service component of another HCPCS “L” code As this is an “unlisted service”, this code can be used to represent items or services related to a cochlear implant or a bone anchored hearing aid that are not otherwise classified; this could include, but is not limited to, bone anchored hearing aid batteries, bone anchored hearing aid fitting and programming and cochlear implant and bone anchored hearing aid troubleshooting; bill Part B S0618 Audiometry for hearing aid evaluation to determine level and degree of hearing loss This code can be used for hearing testing solely related to ordering and fitting a hearing aid; please consult payer agreements prior to use as not all agreements allow for the use of this code; cannot be billed to Medicare or Medicaid S1001 Deluxe item, patient aware (list in addition to code for basic item) This code can be used to represent an upgraded hearing aid; please consult payer agreements prior to use as not all agreements allow for the use of this code V5008 Hearing screening This code represents a pass/fail hearing screening; same as CPT code 92551

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examination and selection/consultation; same as CPT codes 92590‐ 92591 V5011 Fitting/orientation/checking of hearing aid This code represents a hearing aid fitting;

can also be used for a follow‐up hearing aid check if on a separate date of service V5014 Repair/modification of a hearing aid This code covers either monaural or

binaural in‐house or manufacturers repairs, re‐programming, and shell modifications or remakes

V5020 Conformity Evaluation

This code includes real‐ear, functional

gain, and outcome measures; verification V5030 Hearing aid, monaural body worn, air conduction Monaural, air conduction body aid V5040 Hearing aid, monaural body worn, bone conduction Monaural, bone conduction body aid V5050 Hearing aid, monaural, in‐the‐ear Monaural, full shell or low profile hearing

aid

V5060 Hearing aid, monaural, behind‐the‐ear Monaural, behind‐the‐ear hearing aid

V5070 Glasses, air conduction

Monaural, air conduction hearing aid

contained in a pair of glasses

V5080 Glasses, bone conduction

Monaural, bone conduction hearing aid

contained in a pair of glasses V5090 Dispensing fee, unspecified hearing aid This code represents the provider’s

dispensing fee of an unspecified hearing aid (i.e. deep insertion/subscription device, combo masker/aid) when the insurer requests an unbundled cost package

V5095 Semi‐implantable middle‐ear hearing prosthesis This code represents the

acquisition/device cost of an implantable hearing aid

V5100 Hearing aid, bilateral, body worn Binaural, air or bone conduction body aid

V5110 Dispensing fee, bilateral

This code represents the provider’s dispensing fee of a binaural glasses or body aid fitting, a binaural disposable, analog, digitally programmable or digital hearing aid fitting when the insurer requests an unbundled cost package; same as code V5160

V5130 Binaural, in‐the‐ear

Binaural, full shell or low profile hearing

aid

V5140 Binaural, behind‐the‐ear

Binaural, behind‐the‐ear hearing aid

V5150 Binaural, glasses

Binaural, air or bone conduction hearing

aid contained in a pair of glasses V5160 Dispensing fee, binaural

This code represents a provider’s dispensing fee of a binaural glasses or body aid fitting, a binaural disposable, analog, digitally programmable or digital hearing aid fitting when the insurer requests an unbundled cost package; same as code V5110 V5170 Hearing aid, CROS, in‐the‐ear

In‐the‐ear CROS system (includes both the receiver and the transmitter)

V5180 Hearing aid, CROS, behind‐the‐ear Behind‐the‐ear CROS system (includes

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V5190 Hearing aid, CROS, glasses

CROS system that is contained in pair of eyeglasses V5200 Dispensing fee, CROS

This code represents a provider’s dispensing fee any CROS fitting when the insurer requests an unbundled cost package

V5210 Hearing aid, BICROS, in‐the‐ear

In‐the‐ear BICROS system (includes both

the transmitter and the hearing aid/receiver)

V5220 Hearing aid, BICROS, behind‐the‐ear Behind‐the‐ear BICROS system (includes both the transmitter and the hearing aid/receiver)

V5230 Hearing aid, BICROS, glasses

BICROS system that is contained in pair of

eyeglasses V5200 Dispensing fee, BICROS

This code represents a provider’s dispensing fee any BICROS fitting when the insurer requests an unbundled cost package V5241 Dispensing fee, monaural, any type This code represents a provider’s dispensing fee of any monaural hearing aid fitting, including a body aid, glasses, disposable, analog, digitally programmable or digital hearing aid when the insurer requests an unbundled cost package V5242 Hearing aid, analog, monaural, CIC Monaural, analog, CIC aid

V5243 Hearing aid, analog, monaural, ITC Monaural, analog, canal, half‐shell, or mini canal aid

V5244 Hearing aid, digitally programmable analog, monaural, CIC Monaural, digitally programmable, analog, CIC aid

V5245 Hearing aid, digitally programmable, analog, monaural, ITC Monaural, digitally programmable, analog, canal, half‐shell, or mini canal aid V5246 Hearing aid, digitally programmable, analog, monaural, ITE Monaural, digitally programmable,

analog, ITE or Low Profile aid V5247 Hearing aid, analog, digitally programmable, monaural, BTE Monaural, digitally programmable,

analog, BTE aid

V5248 Hearing aid, analog, binaural, CIC Binaural, analog, CIC aids

V5249 Hearing aid, analog, binaural, ITC Binaural, analog, canal, half‐shell, or mini canal aids

V5250 Hearing aid, digitally programmable analog, binaural, CIC Binaural, digitally programmable, analog, CIC aids

V5251 Hearing aid, digitally programmable, analog, binaural, ITC Binaural, digitally programmable, analog, canal, half‐ shell, or mini canal aids V5252 Hearing aid, digitally programmable, analog, binaural, ITE Binaural, digitally programmable, analog,

ITE or Low Profile aids

V5253 Hearing aid, analog, digitally programmable, binaural, BTE Binaural, digitally programmable, analog, BTE aids

V5254 Hearing aid, digital, monaural, CIC Monaural, digital, CIC aid

V5255 Hearing aid, digital, monaural, ITC Monaural, digital, canal, half‐shell, or mini canal aid

V5256 Hearing aid, digital, monaural, ITE Monaural, digital, ITE or Low Profile aid

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V5258 Hearing aid, digital, binaural, CIC Binaural, digital, CIC aids

V5259 Hearing aid, digital, binaural, ITC Binaural, digital, canal, half‐shell, or mini canal aids

V5260 Hearing aid, digital, binaural, ITE Binaural, digital, ITE or Low Profile aids

V5261 Hearing aid, digital, binaural, BTE Binaural, digital, BTE aids

V5262 Hearing aid, disposable, any type, monaural Monaural, disposable hearing aid; please make sure to specify number of aids being purchased

V5263 Hearing aid, disposable, any type, binaural Binaural, disposable hearing aids; please make sure to specify number of aids being purchased

V5264 Earmold/insert, not disposable, any type Custom earmold/earpiece; this can be used for swim plugs, noise plugs, ear protection, etc.; please make sure to specify number of molds being purchased V5265 Earmold/insert, disposable, any type Disposable earmold/earpiece such as a

Comply mold, dome, or insert; please make sure to specify number of molds being purchased

V5266 Battery for use in hearing device Batteries for use in body aids, glasses, hearing aids, cochlear implants, implantable devices, etc.; this is billed per battery so please specify the number of batteries V5267 Hearing aid or assistive listening device/supplies/accessories, not otherwise specified

Remote controls, dri‐aid kits, accessory kits, forced air blowers, cleaning tools, etc.; please specify the number of accessories being billed; this code is also used to represent any FM/DM accessory or supply that is not otherwise listed or captured by another new or existing code; this code is used to represent any FM/DM accessory or supply that is not otherwise listed or captured by another new or existing code.

V5268 Assistive listening device, telephone amplifier, any type Telephone amplifier, whether it is in‐line, portable, an entire phone or a handset; please make sure to specify the number of amplifiers being billed

V5269 Assistive listening device, alerting, any type Alerting devices such as flashing lights, alarms, clocks, etc.

V5270 Assistive listening device, television amplifier, any type Headphones, infrared systems, etc. specifically for listening to the television V5271 Assistive listening device, television caption decoder Television closed captioning device

V5272 Assistive listening device, TDD

TDD for telephone use

V5273 Assistive listening device, for use with a cochlear implant FM system, telephone device, beam former, etc. specifically for use with a cochlear implant

V5274 Assistive listening device, not otherwise specified FM systems, personal amplifiers, etc.

V5275 Ear impression, each

Taking of an earmold impression; please

specify one or two units for one or two ears

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V5281 Assistive listening device, personal FM/DM system, monaural, (1 receiver, transmitter, microphone), any type This code is appropriate when fitting an entire monaural system, regardless of the type of receiver or transmitter used. This does not include the boot, as it is coded separately. V5282 Assistive listening device, personal FM/DM system, binaural, (2 receivers, transmitter, microphone), any type This code is appropriate when fitting an entire binaural system, regardless of the type of receiver or transmitter used. This does not include the boots, as they are coded separately. V5283 Assistive listening device, personal FM/DM neck, loop induction receiver This code is appropriate when dispensing a neck loop receiver in isolation (replacement, extra receiver, etc.) that is coupled with the t‐coil of a hearing aid. V5284 Assistive listening device, personal FM/DM, ear level receiver This code is appropriate when dispensing an ear level receiver in isolation (replacement, extra receiver, etc.). This code is for an ear‐level device for those with normal hearing. The code is per receiver. V5285 Assistive listening device, personal FM/DM, direct audio input receiver This code is appropriate when dispensing a direct audio input receiver (the receiver is the cord which connects to the boot) in isolation (replacement, extra receiver, etc.). This does not include the boot, as each is coded separately. V5286 Assistive listening device, personal blue tooth FM/DM receiver The code is appropriate when dispensing a streamer in isolation (replacement, extra receiver, etc.). V5287 Assistive listening device, personal FM/DM receiver, not otherwise specified This is for any existing or yet to be released receiver that is not represented by another code above. V5288 Assistive listening device, personal FM/DM transmitter assistive listening device This code is appropriate when dispensing any type of FM/DM transmitter in isolation (replacement, extra receiver, etc.). V5289 Assistive listening device, personal FM/DM adapter/boot coupling device for receiver, any type The code is appropriate for the audio boot dispensed in any situation. This code is per boot. A initial, binaural FM fitting would constitute two boots. V5290 Assistive listening device, transmitter microphone, any type This code is appropriate when dispensing any type of FM/DM microphone transmitter in isolation (replacement, extra receiver, etc.).

V5298 Hearing aid, not otherwise specified Any hearing aid that does not fall into any of the other categories; this could include, but is not limited to, a deep insertion/subscription hearing aid and a combination hearing aid/tinnitus masker

V5299 Hearing service, miscellaneous Any other item or service, such as an

extended warranty, l o s s a n d d a m a g e d e d u c t i b l e , o r t i n n i t u s m a s k e r that is not otherwise listed

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Current Procedural Terminology (CPT) is copyright 2014 American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use. The above summary and description of “uses” was prepared by Kim Cavitt, Au.D., Audiological Resources, exclusively for the Academy of Doctors of Audiology. DISCLAIMER: The foregoing information is provided as a resource for our members. ADA makes no recommendation as to the accuracy or suitability of the information for your particular situation. Neither ADA, nor any of its officers, directors, agents, employees, committee members or other representatives shall have any liability for any claim, whether founded or unfounded, of any kind whatsoever, including, but not limited to, any claim for costs and legal fees, arising from the use of these opinions. Updated March 2014