Z96.20 — Presence of otological and audiological implant, unspecified
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- The treatment goals and subsequent documentation of treatment results should specifically demonstrate that speech therapy services are contributing to such improvement.
- Speech therapy must be provided in accordance with an ongoing, written plan of care that is reviewed with and approved by the treating physician and maintained in the medical record.
- The plan of care must be signed by the member's attending physician and the speech therapist.
- The plan of care must include the date of onset or exacerbation of the disorder/diagnosis.
Key Coverage Criteria
- Z96.21 Presence of cochlear implant status
- Z96.3 Presence of artificial larynx
- CPT/HCPCS services covered if selection criteria are met (examples listed in the policy):
- Z96.20 Presence of otological and audiological implant, unspecified
- CPT 92630 - Auditory rehabilitation; pre-lingual hearing loss (covered if selection criteria are met).
- CPT 92633 - Auditory rehabilitation; post-lingual hearing loss (covered if selection criteria are met).
1 Active Policy
AETNA-CPB-0243 — Speech Therapy
Related Codes
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