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2025 HCPCS code V5100

This code represents a bilateral body-worn hearing aid.

Use this code specifically for bilateral body-worn hearing aids. Use separate codes for dispensing fees (e.g., V5110 for bilateral dispensing).

Medical necessity must be established for coverage.This usually requires documentation of significant hearing loss and the rationale for choosing body-worn hearing aids over other options.

An audiologist or hearing healthcare professional is responsible for prescribing, fitting, and adjusting the body-worn hearing aids, ensuring proper function and patient comfort. They also educate patients on device use and maintenance.

IMPORTANT:For monaural body-worn hearing aids, consider V5030 (air conduction) or V5040 (bone conduction). For other types of bilateral hearing aids, see V5130 (in-the-ear), V5140 (behind-the-ear), or V5150 (glasses).

In simple words: This code is for a set of two hearing aids worn on the body, used to help people with significant hearing loss in both ears. The hearing aids have a box that holds the microphone and other parts, and earpieces that go in the ears.

This code covers the provision of a pair of body-worn hearing aids, one for each ear, designed for patients with severe hearing loss. These aids consist of an external box containing a microphone, amplifier, volume control, on/off switch, and battery, connected to earpieces worn by the patient.They are often prescribed for conditions like stenosis of the ear canal, otitis media, wax impaction, bony growth in the ear canal, tympanic membrane perforation, or otosclerosis.

Example 1: A patient with severe bilateral hearing loss due to otosclerosis is fitted with V5100 body-worn hearing aids., An elderly patient with stenosis of both ear canals receives V5100 devices due to difficulty using other types of hearing aids., A patient with bilateral mixed hearing loss following chronic otitis media is provided with V5100 hearing aids to improve their overall hearing ability.

Documentation should include the diagnosis causing hearing loss, audiometric evaluations, the type and style of hearing aid dispensed (V5100), and any relevant medical necessity information.

** Coverage policies for V5100 may vary among payers.Verification of benefits is recommended.

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

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