How To Code Hearing Aids

Hearing aids, hearing tests and follow-up appointments may be covered by medical insurance. Insurance coding and billing for hearing services should be done by an experienced staff member at the clinic providing the service. Medical insurance companies can deny claims with incorrect coding. Incorrect coding can also result in lower benefit payments from an insurance company. Accurate coding is important to the success of your hearing health care practice.

Things You'll Need

• The Current Procedural Technology (CPT) Manual
• The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) Manual

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Instructions

• 1

  Utilize insurance verification forms in your practice. According to Kim Cavitt, Au.D., an insurance verification form should be completed for every patient prior to the hearing aid consultation. When contacting the insurance company, you'll need to ask what kind of codes are required for billing audiological services.

• 2

  Use correct current codes. Insurance companies use CPT (Current Procedural Terminology), HCPCS (Healthcare Common Procedure Coding System) or ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) codes. In 2008, new codes relating specifically to audiology were introduced by the World Health Organization. Codes for hearing aids can be found in a current ICD-9-CM or CPT coding manual.

• 3

  Code hearing aids according to the model or style fitted. HCPCS codes, for example, assign a different code to in-the-ear, completely in-the-ear or behind-the-ear models of hearing aids. ICD-9-CM codes include separate codes for one or two hearing aids. Digital hearing aids may have to be coded according to level of technology.

• 4

  Use current medical or Medicare claim forms when submitting claims. When verifying insurance benefits, ask what kind of claim form should be used. Make sure the correct billing codes are entered in the correct spot on the claim form.

• 5

  Include any required documentation with the claim for hearing aids. Some insurance companies require a copy of the audiometric evaluation, a prescription from a medical doctor or a waiver signed by the patient. When verifying benefits, inquire about any required supporting documentation.