2025 HCPCS code V5240
(Active) Effective Date: N/A Revision Date: N/A Audiology Services - Hearing Aids V Codes (Vision, Hearing, Speech) Feed
This code covers dispensing charges for a binaural contralateral (BiCROS) hearing aid, including fitting, adjustment, instructions, and repair/replacement of parts.
Modifiers may be applicable depending on the specific circumstances, such as those indicating reduced services (52) or multiple procedures (99). Always consult local payer guidelines.
Medical necessity for V5240 is established through a comprehensive audiological evaluation demonstrating significant hearing loss and the need for a BiCROS hearing aid to improve the patient's communication and quality of life.
The audiologist or other qualified hearing healthcare professional responsible for dispensing, fitting, and adjusting the BiCROS hearing aid.
- V Codes (Vision, Hearing, Speech)
- V5008-V5364 (Vision, Hearing, and Speech Services) > V5120-V5267 (Hearing Aids)
In simple words: This code is for the cost of getting and fitting a special type of hearing aid (a BiCROS hearing aid).It includes the cost of the hearing aid itself, fitting it to your ear, showing you how to use it, and fixing any problems that might happen.
This HCPCS code, V5240, reports the charges associated with dispensing a binaural contralateral (BiCROS) hearing aid.These charges encompass the fitting of the device, adjustments to ensure proper function,instructions provided to the patient on its use, the initial supply of the hearing aid, repair or replacement of defective parts under normal use, the labor involved in these services, and the cleaning of the hearing aid following these services.The clinical responsibility lies with the provider performing these dispensing and fitting services.
Example 1: A patient with significant hearing loss in one ear and a lesser degree of hearing loss in the other ear is fitted with a BiCROS hearing aid. Code V5240 is used to bill for the dispensing and fitting of the hearing aid., A patient's BiCROS hearing aid malfunctions due to a manufacturing defect within the warranty period. The audiologist repairs the device and cleans it. Code V5240 is used to bill for the repair and associated services., A patient requires adjustments to their BiCROS hearing aid after a period of time due to changes in their hearing or the fit of the hearing aid. The audiologist makes the necessary adjustments and provides further instructions on its use. Code V5240 covers these services.
Detailed documentation should include:* Patient's audiological assessment demonstrating the need for a BiCROS hearing aid.* Specific model and brand of BiCROS hearing aid dispensed.* Documentation of the fitting, adjustment, and instruction provided to the patient.* Detailed description of any repairs or replacements performed, including the parts used.
** Coverage and reimbursement for V5240 may vary depending on the payer. It's crucial to check payer-specific policies before billing.
- Payment Status: Active
- Specialties:Audiology
- Place of Service:Office, Clinic