Billing and Coding: External Components for Cochlear Implants

External cochlear implant components are covered when a physician certifies they are ineffective for activities of daily living, when a patient's medical condition necessitates a different component, or when the component has reached its reasonable useful life (sound processors: not less than 5 years). Accessories and convenience upgrades are not covered and should be billed under L9900; repairs and labor follow specific HCPCS rules (use L7520 for labor at 15-minute units, L7510 for minor parts when no specific code exists). Battery supplies have defined quantity limits by HCPCS (L8621–L8624) and exceptions must be documented in claim item #19.

"Replacement of an existing cochlear implant external component is covered when a physician certifies the existing component is ineffective to the point of interfering with activities of daily living."

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