UPDATED: New and Revised Codes for Contralateral Routing Hearing Devices Effective January 1, 2019

November 14, 2018

Correction Notice (November 28, 2018): The following news piece has been updated to reflect a correction published by the Centers for Medicare & Medicaid Services deleting HCPCS codes V5170, V5180, V5210, and V5220. 

The Centers for Medicare & Medicaid Services (CMS) has published significant revisions to the family of codes for reporting contralateral routing hearing devices, commonly known as CROS/BiCROS hearing devices, effective January 1, 2019. The changes are an attempt to more accurately describe current hearing aid technology used to treat patients with single sided deafness or patients with some degree of hearing loss in one ear and an unaidable hearing loss in the other. 

CROS/BiCROS codes were originally created in the 1980s for dedicated systems. Advancements in hearing aid technology now allow contralateral routing devices to be configured for a wide range of clinical applications and do not require dedicated systems. As such, the current codes do not clearly describe to payers that the patient is receiving two devices (one hearing aid and one contralateral routing device) regardless of degree of loss in the better ear. Additionally, there is currently no way to report when a single contralateral routing device is provided to a patient who wears an existing hearing aid in the opposite ear.

The original code change proposal application submitted to CMS was a collaborative effort among the American Academy of Audiology (AAA), American Speech-Language-Hearing Association (ASHA), Academy of Rehabilitative Audiology (ARA), and Educational Audiology Association (EAA), as well as hearing aid industry manufacturer Phonak. Although CMS modified our original request, the code set now allows greater flexibility for reporting contralateral routing devices.

ASHA will work with the other audiology organizations to provide clear payer and member education regarding the coding changes. Contact ASHA at reimbursement@asha.org, if it appears that a payer is not appropriately implementing the new and revised codes.

New Codes

The following new codes—labeled contralateral routing device or system—should be used to report current contralateral routing technology. Use the monaural codes to report one contralateral routing device. Use the binaural codes to report one hearing aid and one contralateral routing device (i.e., a contralateral routing system).

V5171  Hearing aid, contralateral routing device, monaural, in the ear (ite)

V5172  Hearing aid, contralateral routing device, monaural, in the canal (itc)

V5181  Hearing aid, contralateral routing device, monaural, behind the ear (bte)

V5211  Hearing aid, contralateral routing system, binaural, ite/ite

V5212  Hearing aid, contralateral routing system, binaural, ite/itc

V5213  Hearing aid, contralateral routing system, binaural, ite/bte

V5214  Hearing aid, contralateral routing system, binaural, itc/itc

V5215  Hearing aid, contralateral routing system, binaural, itc/bte

V5221  Hearing aid, contralateral routing system, binaural, bte/bte

Revised Codes

The following codes are revised from “CROS or BiCROS” to “monaural or binaural contralateral routing” to align with the new codes. Use V5200 for dispensing one monaural contralateral device. Use V5240 for dispensing two devices (e.g., binaural contralateral routing system, legacy CROS or BiCROS system).

V5190  Hearing aid, contralateral routing, monaural, glasses

V5200  Dispensing fee, contralateral, monaural

V5230  Hearing aid, contralateral routing system, binaural, glasses

V5240  Dispensing fee, contralateral routing system, binaural

Updated Information (November 28, 2018): The four current HCPCS codes—V5170 (Hearing aid, CROS, in the ear), V5180 (Hearing aid, CROS, behind the ear), V5210 (Hearing aid, BiCROS, in the ear), and V5220 (Hearing aid, BiCROS, behind the ear)—will be deleted. All contralateral routing devices and systems should be reported using the new codes outlined above. Contact payers directly to determine their guidelines for implementation of the new and revised codes.   

Original Post (November 14, 2018): There are also four existing HCPCS codes that will remain unchanged—V5170 (Hearing aid, CROS, in the ear), V5180 (Hearing aid, CROS, behind the ear), V5210 (Hearing aid, BiCROS, in the ear), and V5220 (Hearing aid, BiCROS, behind the ear). These codes were not deleted to allow continued reporting of older analog technology.

ASHA will provide audiologists with updates on the use of these new and revised codes through The ASHA Leader, ASHA Headlines, and ASHA’s billing and reimbursement website.

Questions?

For questions, please contact ASHA’s health care and education policy team at reimbursement@asha.org

 


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