2025 HCPCS code V5050
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Hearing Services - Hearing Aid, Monaural V Codes (Vision, Hearing, and Speech Services) Feed
Supply of a monaural in-the-ear (ITE) hearing aid.
Modifiers LT (left) and RT (right) are applicable to specify the side of the hearing aid fitting.
Medical necessity for hearing aids is established by documentation demonstrating significant hearing loss impacting the patient’s communication and daily life.The type and style of hearing aid (ITE) should be justified by the patient’s specific anatomy and degree of hearing loss.
Audiologist or other qualified hearing healthcare professional responsible for assessment, fitting, and dispensing of the hearing aid.
In simple words: This code is for a hearing aid that fits inside one ear.It's custom-made to fit the patient's ear and helps people hear better in that ear.It's used for various types of hearing loss.
This HCPCS code, V5050, covers the provision of a monaural in-the-ear (ITE) hearing aid for unilateral hearing loss.ITE hearing aids are custom-fitted to the patient's ear and come in full-shell or half-shell styles.The device contains essential electronic components such as a microphone and battery.Indications for use include hearing loss resulting from conditions like outer or middle ear stenosis, otitis media, wax impaction, bony growths in the ear canal, tympanic membrane perforation, or otosclerosis.
Example 1: A 65-year-old patient presents with unilateral conductive hearing loss due to otosclerosis.An ITE hearing aid (V5050) is custom-fitted and dispensed to improve hearing in the affected ear., A 40-year-old patient experiences mild sensorineural hearing loss in their left ear due to noise exposure. A left-sided ITE hearing aid (V5050-LT) is provided to address the hearing loss., A 78-year-old patient has significant hearing loss in their right ear caused by cerumen impaction.Following cerumen removal, a right-sided ITE hearing aid (V5050-RT) is fitted to restore hearing function.
* Detailed audiological assessment report including pure tone audiometry and speech testing.* Documentation of the hearing aid fitting procedure.* Patient's medical history including underlying causes of hearing loss.* Type of hearing aid dispensed (ITE, full-shell or half-shell).* Verification of hearing aid functionality.
** Coverage and reimbursement for hearing aids may vary significantly depending on the payer and patient's insurance plan. It is essential to confirm coverage prior to dispensing the hearing aid.The specific model and manufacturer of the hearing aid should be documented.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Audiology, Otolaryngology
- Place of Service:Office, Clinic