HCPCS 2019: Update CROS/BiCROS Hearing Device Codes for a Better Clinical Match

For those of you who report contralateral routing hearing aid devices (CROS/BiCROS), here’s what you need to know about the big makeover these codes got for 2019.

Catch the Little Differences in Code Descriptors

As noted in a previous blog post about HCPCS 2019, the hearing aid codes will test your ability to spot tiny variations in code descriptors. (But as a coder, you are already all about the details, right?)

Pay particular attention to the ends of the descriptors for these new codes. To help you choose the correct code, the documentation should specify in the ear (ITE), in the canal (ITC), or behind the ear (BTE) for each ear involved.

Monaural

  • 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))

Binaural

  • 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)

Don’t Miss Changes to Existing Hearing Aid Codes

In addition to the new codes, there are also some revisions and deletions you’ll need to know.

Revisions: HCPCS 2019 changes the related glasses mounting and dispensing fee code descriptors to be more in line with the wording of the new codes’ descriptors.

2018

  • V5190 (Hearing aid, CROS, glasses)
  • V5200 (Dispensing fee, CROS)
  • V5230 (Hearing aid, BICROS, glasses)
  • V5240 (Dispensing fee, BICROS)

2019

  • 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)

Deletions: To make room for the new, more specific codes, HCPCS 2019 deletes the codes below:

  • V5170 (Hearing aid, CROS, in the ear)
  • V5180 (Hearing aid, CROS, behind the ear)
  • V5210 (Hearing aid, BiCROS, in the ear)
  • V5220 (Hearing aid, BiCROS, behind the ear).

What’s the Intent for These New Codes?

In short, the new HCPCS codes offer a better approach to reporting the variety of configurations clinicians currently may use for these CROS/BiCROS hearing devices. These hearing devices are used to treat patients with single-sided deafness or unaidable hearing loss in one ear and some degree of hearing loss in the other, according to the American Speech-Language Hearing Association (ASHA). For instance, if the patient requires an in the ear aid in one ear and an in the canal aid for the other ear, you’ll now be able to represent that using code V5212.

According to the HCPCS Public Meeting Agenda for June 5, 2018, audiology and speech organizations including the American Academy of Audiology, ASHA, Academy of Rehabilitative Audiology, and Educational Audiology Association, together with hearing aid manufacturer Phonak, requested eight revisions and 13 additions because the 2018 codes caused problems when trying to report the technology currently available. With nine additions, four revisions, and four deletions, the changes aren’t exactly what the organizations requested, but they do expand code options for CROS/BiCROS devices.

What About You?

Do you find these 2019 HCPCS codes adequate for the hearing devices you report?

 

About 

Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

, , ,

Leave a Reply