Audiologists are one step closer to being able to use 10 new codes for billing FM/DM systems beginning January 1, 2013, as a result of collaborative advocacy among audiology organizations.
The Centers for Medicare and Medicaid Services (CMS) has given preliminary acceptance to 10 codes in the Healthcare Common Procedure Coding System (HCPCS) Level II code group for frequency modulated/digitally modulated systems. This code category identifies supplies, equipment, devices, and procedures not found in the Current Procedural Terminology (©American Medical Association).
ASHA—and the American Academy of Audiology (AAA), Academy of Doctors of Audiology, Academy of Rehabilitative Audiology, Directors of Speech and Hearing Programs in State Health and Welfare Agencies, and the Educational Audiology Association—submitted an application to CMS for 11 new HCPCS codes. Two codes cover complete FM systems (monaural and binaural), and other codes cover various individual components (receivers, microphones, transmitters) and accessories.
In a preliminary decision in May, the HCPCS Coding Workgroup accepted 10 of the proposed "V" codes and revised the existing HCPCS code (V5267), currently defined as "Hearing aid supplies/accessories," to instead read "Hearing aid or assistive listening device/supplies/accessories, not otherwise specified."
Representatives from AAA and ASHA attended the May HCPCS meeting on behalf of the entire audiology work group. This public meeting was designed to provide a forum for members of the general public to present additional information about specific requests for new codes for products, supplies, and services. CMS also had the opportunity to obtain industry and public reaction to the preliminary coding and payment methodology recommendations.
The ASHA and AAA representatives expressed appreciation for the initial acceptance of the 10 FM system codes and offered suggestions for minor edits and revisions. They also noted the recommendation to revise V5267, and gave reasons to support of a separate FM/DM system accessories code.
Hearing aids and FM systems are not covered under Medicare, but many Medicaid programs and private insurers will use this new code group in their fee schedules. With final acceptance of the new codes, which will be released in the 2013 Medicare Physician Fee Schedule in November to take effect January 1, 2013, audiologists will be able to delineate FM/DM-related equipment from HCPCS code V5274 (Assistive listening device, not otherwise specified).