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2025 HCPCS code V5200

Dispensing fee for a monaural contralateral hearing aid, including fitting, adjustment, instructions, and initial repairs/replacements.

This code is used for the dispensing fee only and does not include the cost of the hearing aid itself.In some cases, dispensing fees might be limited by payer policies (e.g., once every five years).

Medical necessity for a contralateral hearing aid (CROS or BiCROS) is established when audiologic testing confirms hearing loss in one or both ears and the device is deemed clinically appropriate to improve the patient's hearing and quality of life.

The dispensing of the monaural contralateral hearing aid is performed by an audiologist or other qualified healthcare professional.This includes the fitting, adjustment, instructions, repairs, and maintenance of the hearing aid initially after dispensing.

In simple words: The fee covers the cost of setting up and teaching you how to use a single hearing aid that routes sound from your impaired ear to your better ear.This includes the fitting, adjustments, instructions on how to use it, and fixing or replacing any parts that break soon after you get it.

This code represents the dispensing fee for a monaural contralateral routing of signal hearing aid. It covers professional services associated with the initial provision of the device, including fitting, adjustments, patient instructions, and any necessary repairs or replacements of defective parts during the initial dispensing period. It also includes the labor for cleaning and maintenance.

Example 1: A patient with single-sided deafness is fitted with a CROS hearing aid, and the code V5200 is used to bill for the dispensing fee., A patient's existing monaural CROS aid malfunctions and is replaced under warranty. V5200 is billed for the replacement, as it falls within the initial dispensing period and involves fitting and adjustment by a healthcare professional., A patient is initially fitted with a monaural CROS hearing aid. V5200 is used to bill for the dispensing fee, encompassing fitting, adjustment, and instructions.

Documentation should include the type of hearing aid dispensed, date of service, and details of the professional services provided (e.g., fitting, adjustment, instructions, repairs). Medical necessity for the hearing aid should also be documented, usually by means of audiologic testing results showing hearing loss.

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