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.
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
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.
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.
will work with the other audiology organizations to provide clear payer and
member education regarding the coding changes. Contact ASHA at email@example.com,
if it appears that a payer is not appropriately implementing the new and
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,
V5212 Hearing aid, contralateral routing system,
V5213 Hearing aid, contralateral routing system,
V5214 Hearing aid, contralateral routing system,
V5215 Hearing aid, contralateral routing system,
V5221 Hearing aid, contralateral routing system,
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,
V5200 Dispensing fee, contralateral, monaural
V5230 Hearing aid, contralateral routing system,
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.
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, please contact ASHA’s health care and education policy team at firstname.lastname@example.org.