V5214 — Hearing aid, contralateral routing system, binaural, itc/itc
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Documentation Required
- No documentation requirements (medical records, test results, clinical documentation) are specified in the provided document text.
- The document's Table of Contents references sections ('Description', 'Coverage Limitations', 'References', 'Coverage Determination Coding Information Change Summary') but none of these sections' contents were provided to extract documentation requirements.
- No documentation requirements are stated in this document chunk.
- No documentation requirements are specified in this excerpt.
Key Coverage Criteria
- No covered indications, diagnoses, conditions, or clinical scenarios are specified in the provided document text. (The document includes a Table of Contents with 'Description' and 'Coverage Limitations' but the content of those sections was not included in the provided text.)
- Hearing loss (HL) results in partial or total inability to hear sound in one or both ears.
- One or more parts of the auditory system can be the cause, including the outer ear, middle ear, inner ear, auditory nerve or brain.
- Causes of hearing loss include genetic defects, congenital malformations, disease, infection, toxicity, trauma or as a natural result of aging.
- Conductive hearing loss - occurs when sound cannot efficiently pass through the outer or middle ear (eg, earwax buildup, ear infections, eardrum perforation).
- Sensorineural hearing loss (SNHL) - caused by damage to the cochlea (inner ear) or the auditory nerve (eg, age-related hearing loss, noise exposure).
1 Active Policy
HUMANA-AIR-CONDUCTION-HEARING-AIDS-SC-MEDICAID — Air Conduction Hearing Aids - MEDICAID - SOUTH CAROLINA
Related Codes
Have a follow-up question?
Ask Verity about documentation requirements, denial risks, or coverage in your state.