V5243 — Hearing aid, analog, monaural, itc (in the canal)
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
Key Coverage Criteria
- Binaural testing shows improved speech recognition using bilateral devices.
- Binaural air conduction hearing aids are consideredmedically necessarywhenBOTHof the following criteria are met (A and B):
- Both ears meet the criteria listed above in A and B;and
- Air conduction hearing aid devices are consideredmedically necessaryfor the treatment of hearing loss whenALLof the following criteria are met (A and B):
- The hearing loss is due to one of the following etiologies:Sensorineural hearing loss;orMixed hearing loss;orConductive hearing loss, which has been:unresponsive to medical interventions;andunresponsive to surgical interventions or not amenable to surgical correction;and
- Sensorineural hearing loss;or
1 Active Policy
ANTHEM-CG-DME-37 — CG-DME-37 Air Conduction Hearing Aids
Related Codes
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