2025 HCPCS code V5190
(Active) Effective Date: N/A Revision Date: N/A Hearing Services - Hearing Aids Vision, Hearing, and Speech Services Feed
Supply of a spectacles CROS hearing aid (contralateral routing of sound) for patients with unilateral hearing loss.
Modifiers may apply depending on the circumstances of service (e.g., modifier -50 for bilateral procedures if applicable, though unlikely with a CROS device). Check with the payer for allowed modifiers.
Medical necessity for a CROS hearing aid is established by audiometric findings demonstrating significant unilateral hearing loss and the absence of significant hearing loss in the contralateral ear. The patient must demonstrate a hearing loss that negatively impacts their daily activities.Documentation should show that a CROS hearing aid is the appropriate solution given the patient's hearing profile and lifestyle needs.
Audiologist or hearing aid specialist.The clinician assesses the patient's hearing loss, determines the suitability of a CROS hearing aid, fits the device, and provides instructions on its use.
In simple words: This code covers the cost of a special type of hearing aid that attaches to glasses. It's for people who can hear well in one ear but not the other. The hearing aid picks up sounds from the bad ear and sends them to the good ear, making it easier to hear.
This HCPCS code, V5190, represents the supply of a spectacles hearing aid with contralateral routing of sound (CROS). This device is typically used by patients experiencing hearing loss in one ear while maintaining normal or near-normal hearing in the other.The hearing aid comprises an ear mold, microphone, amplifier, and on/off switch integrated into the glasses frame. The microphone is positioned on the side with hearing loss to capture sound, while the amplifier is located on the better-hearing side, allowing for improved sound perception.This code specifically covers the supply of the hearing aid itself; separate codes are used for the dispensing fee and other supplies (e.g., batteries).
Example 1: A 60-year-old patient presents with unilateral sensorineural hearing loss in their right ear.An audiologist determines that a CROS hearing aid is appropriate.Code V5190 is used to bill for the supply of the CROS hearing aid., A 45-year-old patient with sudden onset unilateral conductive hearing loss in their left ear, after a middle ear infection, is fitted with a CROS hearing aid. Code V5190 is billed for the supply of the hearing aid., A 72-year-old patient with a history of unilateral hearing loss due to acoustic neuroma surgery is fitted with a custom-made CROS hearing aid integrated into their glasses. Code V5190 is billed for the supply of this device.The dispensing fee is coded separately.
* Patient's history and physical examination, focusing on hearing assessment.* Audiometric testing results demonstrating unilateral hearing loss.* Documentation supporting the medical necessity of a CROS hearing aid.* Detailed description of the supplied hearing aid (manufacturer, model, serial number).* Documentation of the fitting and instruction provided to the patient.
** This code is for the supply only.Other codes may be necessary for evaluation and management, fitting, and other related services.Always check payer guidelines for specific coverage and reimbursement policies. The information provided here should not be considered as a substitute for professional coding advice.
- Payment Status: Active
- Specialties:Audiology, Otolaryngology
- Place of Service:Office, Outpatient Hospital, Hearing Aid Clinic