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2025 HCPCS code V5030

Supply of a monaural air conduction hearing aid (ACHA).

Appropriate modifiers (LT or RT) should be appended to indicate the side of application. Refer to payer specific guidelines for coverage and reimbursement.

Modifiers LT (left side) and RT (right side) are applicable.

Hearing loss impacting daily communication and quality of life, and the hearing aid is deemed medically necessary to improve hearing ability.

Audiologist or other qualified healthcare professional fitting and dispensing the hearing aid.

IMPORTANT:V5040 (Hearing aid, monaural, body worn, bone conduction); V5100 (Hearing aid, bilateral, body worn)

In simple words: This code is for providing a hearing aid that's worn in one ear.It helps people who have trouble hearing because of ear problems like earwax buildup or other issues.The hearing aid comes with a custom-fit piece that goes in the ear.

This HCPCS code, V5030, covers the supply of a body-worn monaural air conduction hearing aid (ACHA) for patients experiencing hearing loss.ACHAs are beneficial for individuals with hearing loss resulting from conditions such as ear canal stenosis, otitis media, wax impaction, bony growths in the ear canal, tympanic membrane perforation, or otosclerosis. The hearing aid requires an ear mold for proper fit and sound amplification.

Example 1: A 65-year-old patient presents with significant hearing loss in their right ear due to otosclerosis.The audiologist recommends and fits a monaural air conduction hearing aid (right ear)., A 40-year-old patient with impacted earwax experiences significant hearing loss in their left ear. After wax removal, an audiologist fits a monaural air conduction hearing aid (left ear)., A 70-year-old patient with a history of chronic otitis media and resulting hearing loss in their left ear receives a monaural air conduction hearing aid.

* Patient's medical history, including hearing loss details and underlying conditions.* Audiological evaluation results (audiogram).* Documentation of hearing aid fitting and dispensing.* Verification of the hearing aid's specifications (model, type, serial number).

** This code is specific to monaural air conduction hearing aids.Other codes exist for bone conduction hearing aids or bilateral hearing aids.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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