More than one (1) headband per year will be denied as not medically necessary. One (1) headband per year may be considered medically necessary. BAHA for SSD is also indicated for any individual who is indicated for an air- conduction contralateral routing of signals (AC CROS) hearing aid, but who for some reason cannot or will not use an AC CROSīAHA may also be consider medically necessary for the individuals who cannot wear conventional hearing aids due to tumors of the external canal and/or tympanic cavity or dermatitis of the external canal or severe chronic external otitis or otitis media, or hypersensitivity reactions to earmolds.įor bilateral implantation, individuals should meet the above audiologic criteria, and have a symmetrically conductive or mixed hearing loss as defined by a difference between left and right side bone conduction threshold of less than 10 dB on average measured at 0.5, 1, 2 and 3 kHz, or less than 15 dB at individual frequencies.As an alternative to an air-conduction CROS hearing aid in individuals five (5) years of age and older with single-sided sensorineural deafness and normal hearing in the other ear and the pure tone average air conduction threshold of the normal ear should be better than 20 dB measured at 0.5, 1, 2, and 3 kHz.A pure tone average (PTA) bone-conduction threshold measured at 0.5, 1, 2, and 3 kHz of better than or equal to 45 dB (OBC and BP100 devices), 55 dB (Intenso device) or 65 dB (Cordele II device).The following audiologic criteria must be met:
There must be a functioning cochlea or cranial nerve VIII for the BAHA to work Viral infections (CMV, HSV, Measles, or others) Single sided deafness (SSD) due to: (allow stimulation of the functioning cochlea) Infection of the ear canal resulting in chronic draining ears,įixation of the ossicles (middle ear bones), This includes at leastĬongenital or surgically induced malformation (e.g., atresia) of the external ear, ear canal, or middle ear, The BAHA is indicated for conductive, mixed hearing loss or unilateral deafness hearing loss. All rights reserved.Unilateral or bilateral fully or partial implantable Bone Anchored Hearing Devices (BAHA), may be considered medically necessary as prosthetic devices when the following indications and criteria are met: © Copyright 2017 Health Care Service Corporation.
V5259 hearing aid, digital, binaural, CIC.
#V5261 hearing aid code#
Binaural hearing aid codes allow providers to save time by billing a single Current Procedural Terminology (CPT ®) code for members requiring bilateral hearing aids.
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