Coding and Billing for CROS and BiCROS Systems
The Academy of Doctors of Audiology (ADA), the American Academy of Audiology (AAA), and the American Speech-Language-Hearing Association (ASHA) collaborated on the following guidance regarding the appropriate billing and coding of CROS (Contralateral Routing Of Signal) and BiCROS (Bilateral Contralateral Routing Of Signal) systems.
The HCPCS (health care common procedure system) descriptions and HCPCS codes that represent CROS and BiCROS systems are:
- V5170: Hearing aid, CROS, in the ear
- V5180: Hearing aid, CROS, behind the ear
- V5190: Hearing aid, CROS, glasses
- V5210: Hearing aid, BiCROS, in the ear
- V5220: Hearing aid, BiCROS, behind the ear
- V5230: Hearing aid, BiCROS, glasses
Each of these codes includes both the transmitter and the receiver (CROS) or the transmitter and the receiver/hearing aid (BiCROS). Typically, no other hearing aid device code (i.e., V5257) should be billed in addition to the specific CROS or BiCROS code used.
Unless you are specifically instructed to do so by the payer, it may be considered a fraudulent billing practice to submit a claim for both a CROS instrument and a hearing aid. Please read and review your Medicaid and third-party payer contracts to determine the coverage specifics related to CROS and BiCROS for each payer. State Medicaid programs may have specific coding and coverage guidance unique to provision of these devices in a particular state. As indicated in previous joint communications, it may be useful to itemize/unbundle the hearing aid claims to maximize third-party reimbursement of these devices.