Medical Billing Coding - Help with Durable Medical Equipment Code for Hearing Aid, cpt, codes
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Thread Topic: Help with Durable Medical Equipment Code for Hearing Aid
Topic Originator: Aden
Post Date April 5, 2016 @ 11:16 AM
Help with Durable Medical Equipment Code for Hearing Aid

April 5, 2016 @ 11:16 AM Reply  |  Email Friend   |  |Print  |  Top

Hi all,
I'm looking for help with the durable medical equipment code for the Seimens Pure Binax 3bx hearing aid I bought. I got my first hearing aid in October and have gotten reimbursed by my insurance for the hearing evaluation associated with the hearing aid placement, but I want to get reimbursed for the actual device. The people who provided me with the hearing aid have given me multiple wrong codes resulting in denied claims at my insurance company. At this point, I am confident that I have everything else correct, but before I resubmit my claim I want to make sure I have the right code for the hearing aid its self. I have binaural hearing loss, but only wear a hearing aid in one ear at this point, and I believe I have a monaural, digital, behind the ear hearing aid, which should be V5257, but I would like to get confirmation of this before I submit to my insurance. Would anyone be kind enough to take a look at the hearing aid I bought and make sure that seems like the right code to use?
I was also given the following information: ICD.10 Code H90.2 (bilateral conductive hearing loss - I have two permanently ruptured ear drums) and procedure code 92557 (comprehensive audiometry threshold evaluation and speech recognition). Both of those seem correct, but I want to make sure they are compatible with the durable medical equipment code that I plan to use. One final question - I have already been paid by my insurance company for the hearing evaluation (procedure code listed above). When I submit a new claim to be reimbursed for the actual hearing aid, do I need to include the procedure code again, even thought i have already been reimbursed for the "procedure" portion of the hearing aid placement? Does every claim need a procedure code, even if its just for durable medical equipment? I'm worried if I unnecessarily include the procedure code they will see I have already been reimbursed based on this procedure code (the evaluation portion of the hearing aid claim) and deny it.
Thank you SO much for any assistance! Getting this claim submitted correctly has been quite the learning process for me. :)

April 6, 2016 @ 6:04 AM Reply  |  Email Friend   |  |Print  |  Top

Why was the claim denied?

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