HCPCS CODING REFERENCE CHART

Transcription

1 HCPCS CODES HCPCS CODING REFERENCE CHART HCPCS CODE DESCRIPTIONS COMMENTS L7510 Repair of prosthetic device, repair or replace minor parts This code covers 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, 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, 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 L8618 L8619 L8621 L8622 L8623 Transmitting coil for use with cochlear implant device, Transmitter cable for use with cochlear implant device, Cochlear implant, external speech processor and controller, integrated system, Zinc air battery for use with cochlear implant device,, each Alkaline battery for use with cochlear implant device, any size,, each Lithium ion battery for use with cochlear implant device speech processor, other than ear level,, each 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 transmitter cable to a cochlear implant recipient; this is not to be used to bill an initial device fitting; bill Part B This code covers the acquisition/device cost of a or upgraded integrated speech processor/controller for use with a cochlear implant; bill Part B This code is used to bill for multiplied; bill Part B This code is used to bill for multiplied; bill Part B This code is used to bill for

2 multiplied; bill Part B L8624 Lithium ion battery for use with cochlear implant device speech This code is used to bill for processor, ear level,, each multiplied; bill Part B L8627 Cochlear implant, external speech processor, component, This code covers the acquisition/device cost of a or upgraded speech processor for use with a cochlear implant; bill Part B L8628 Cochlear implant, external controller component, This code covers the acquisition/device cost of a or upgraded controller for use with a cochlear implant; bill Part B L8629 L8690 L8691 L8692 L8693 L9900 S0618 S1001 Transmitting coil and cable, integrated for use with cochlear implant device, Auditory osseointegrated device, includes all internal and external components Auditory osseointegrated device, external sound processor, Auditory osseointegrated device, external sound processor, used without osseointegration, body worn, includes headband or other mean of external attachment Auditory osseointegrated device abutment, any length, only Orthotic and prosthetic supply, accessory and/or service component of another HCPCS L code Audiometry for hearing aid evaluation to determine level and degree of hearing loss Deluxe item, patient aware (list in addition to code for basic item) 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 This code is used to bill a bone anchored hearing aid system; billed by implanting facility This code is used to bill a, bone anchored hearing aid, external sound processor; bill Part B This code is for a bone anchored hearing aid that is not implanted but rather worn with a soft band; bill Part B This is a code for a abutment; this should be billed by implanting facility 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 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 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 V5010 Assessment for hearing aid This code represents a hearing aid

3 examination and selection/consultation; same as CPT codes 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 both the receiver and the transmitter)

4 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 V5257 Hearing aid, digital, monaural, BTE Monaural, digital, BTE aid

5 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

6 V5281 V5282 V5283 V5284 V5285 V5286 V5287 V5288 V5289 V5290 Assistive listening device, personal FM/DM system, monaural, (1 receiver, transmitter, microphone), any type Assistive listening device, personal FM/DM system, binaural, (2 receivers, transmitter, microphone), any type Assistive listening device, personal FM/DM neck, loop induction receiver Assistive listening device, personal FM/DM, ear level receiver Assistive listening device, personal FM/DM, direct audio input receiver Assistive listening device, personal blue tooth FM/DM receiver Assistive listening device, personal FM/DM receiver, not otherwise specified Assistive listening device, personal FM/DM transmitter assistive listening device Assistive listening device, personal FM/DM adapter/boot coupling device for receiver, any type Assistive listening device, 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. 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. a neck loop receiver in isolation (, extra receiver, etc.) that is coupled with the t coil of a hearing aid. an ear level receiver in isolation (, extra receiver, etc.). This code is for an ear level device for those with normal hearing. The code is per receiver. a direct audio input receiver (the receiver is the cord which connects to the boot) in isolation (, extra receiver, etc.). This does not include the boot, as each is coded separately. The code is appropriate when dispensing a streamer in isolation (, extra receiver, etc.). This is for any existing or yet to be released receiver that is not represented by another code above. any type of FM/DM transmitter in isolation (, extra receiver, etc.). 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. any type of FM/DM microphone transmitter in isolation (, 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, loss and damage deductible, or tinnitus masker that is not otherwise listed

7 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