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    v1.0.31
    OpenPayerBilling CodesProsthetic ProceduresHCPCS hcpcs-l8691-auditory-osseointegrated-external-sound-processor-replacement
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    HCPCS Level II L8691: Auditory Osseointegrated External Sound Processor, Replacement Only

    HCPCS Level II code L8691 describes an auditory osseointegrated device external sound processor, billed for replacement only and excluding the transducer/actuator; the service represents a discrete device supply for a patient's hearing implant system, typically provided as a durable medical equipment/device replacement and furnished in outpatient clinics, audiology centers, or specialty ENT offices where implant-related components are dispensed and fitted.

    For related coverage guidance, see recent payer policy updates: Speech Therapy for Autism Disorders - Medical Policy, Sensory Integration Therapy and Auditory Integration Training, Skilled Nursing and Skilled Rehabilitation Services (Outpatient).

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 48-year-old adult with long-standing unilateral conductive hearing loss from chronic otitis media and multiple failed tympanoplasties presents for rehabilitation with an osseointegrated bone conduction system. The patient previously underwent implantation of a percutaneous or transcutaneous abutment with osseointegrated fixture and now requires replacement of the external sound processor. The audiologist documents persistent speech-recognition deficits in noisy environments and confirms that the implanted abutment and internal components are intact on physical and imaging exam. The external sound processor is replaced on the affected side during an outpatient clinic visit. Billing uses the HCPCS Level II code L8691 for the external sound processor replacement. Typical workflow includes pre-visit audiologic verification, device ordering, in-person device exchange and fitting, post-replacement programming and verification with real-ear or aided speech testing, documentation of device serial numbers and warranty status, and note of laterality using modifier LT or RT as applicable. Typical site of service is an outpatient audiology clinic, ambulatory surgery center or hospital outpatient department depending on institutional policy and whether additional surgical services are required.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    92557Comprehensive audiometry threshold evaluation and speech recognitionPerformed before and after replacement to document audiometric benefit of the new external processor
    92601Diagnostic analysis of cochlear implant or other implanted hearing device, patient, any combination of programming, adjustments, or maintenanceUsed for programming and adjustments of osseointegrated external sound processors when billable per payer guidance
    92590Hearing aid examination and selection; monauralUsed when counseling and selection of the external processor is provided as part of the patient encounter
    97760Orthotic(s) and/or prosthetic(s) fitting, adjustment(s) and/or training, upper extremity, lower extremity, and/or trunk, initial encounterMay be used by certified prosthetic/orthotic suppliers for device fitting-related services when applicable
    99070Supplies and materials (eg, device replacement parts) provided by the physician over and above those usually included with the office visitUsed for non-routine replacement components or accessories if payer allows billing alongside office visit codes

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    8PModifier 8P—Performance Measure Reporting Modifier – Action Not Performed, Reason Not Otherwise Specified— is appended only to CPT Category II quality-reporting codes to indicate that the specified…- Use modifier -8P only with CPT Category II codes when the quality-measure action was not performed for an eligible patient and there is no documented reason in the medical record for omitting the…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
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    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    367A00000X
    207L00000X
    204D00000X
    1710I1003X
    207YP0228X
    282NR1301X
    347D00000X
    261QS1000X

    Related ICD-10-CM Codes

    23 rows

    ICD-10-CM CodeDescription
    B96.89Other specified bacterial agents as the cause of diseases classified elsewhere
    G51.0Bell's palsy
    G51.9Disorder of facial nerve, unspecified
    G90.09Other idiopathic peripheral autonomic neuropathy
    H61.23Impacted cerumen, bilateral
    H81.10Benign paroxysmal vertigo, unspecified ear
    H81.11Benign paroxysmal vertigo, right ear
    H81.13Benign paroxysmal vertigo, bilateral
    H83.09Labyrinthitis, unspecified ear
    H90.11Conductive hearing loss, unilateral, right ear, with unrestricted hearing on the contralateral side

    Showing 1–10 of 23

    Related Payer Policy Updates

    Specialty: Physical Medicine, Rehab & Therapies1 / 2

    10 rows

    PolicyPayerEffective Date
    Speech Therapy for Autism Disorders - Medical PolicyHealth-New-England2026-12-01
    Sensory Integration Therapy and Auditory Integration TrainingColorado Rocky Mountain Health Plans2026-11-01
    Skilled Nursing and Skilled Rehabilitation Services (Outpatient)Anthem2026-10-01
    Habilitation and Rehabilitation Therapy (Occupational, Physical, and Speech) (for New Mexico Only)UnitedHealthcare2026-10-01
    Physical Therapy/Medicine Corporate Medical Policybcbsvermont2026-10-01
    Occupational Therapy Corporate Medical Policybcbsvermont2026-10-01
    Speech Language Pathology/Therapy Services Corporate Medical Policybcbsvermont2026-10-01
    Cognitive Rehabilitation Corporate Medical Policybcbsvermont2026-10-01
    Biomagnetic TherapyConnectiCare2026-09-11
    Habilitation and Rehabilitation Therapy (Occupational, Physical, and Speech) (for Idaho Only)UnitedHealthcare2026-09-01

    Related Codes

    HCPCS-L5000-PARTIAL-FOOT-SHOE-INSERT-LONGITUDINAL-ARCH-TOE-FILLER

    HCPCS Level II L5000: Partial Foot Shoe Insert with Longitudinal Arch, Toe Filler

    HCPCS-L5010-PARTIAL-FOOT-MOLDED-SOCKET-ANKLE-HEIGHT-TOE-FILLER

    HCPCS L5010: Partial Foot Molded Socket, Ankle Height, With Toe Filler

    HCPCS-L5020-PARTIAL-FOOT-MOLDED-SOCKET-TIBIAL-TUBERCLE-TOE-FILLER

    HCPCS L5020: Partial Foot Molded Socket with Toe Filler

    HCPCS-L5050-ANKLE-SYMES-MOLDED-SOCKET-SACH-FOOT

    HCPCS L5050: Ankle/Symes Molded Socket with SACH Foot

    HCPCS-L5060-ANKLE-SYMES-METAL-FRAME-MOLDED-LEATHER-SOCKET-ARTICULATED-ANKLE-FOOT

    HCPCS L5060: Ankle/Symes Metal Frame with Molded Leather Socket

    HCPCS-L5100-BELOW-KNEE-MOLDED-SOCKET-SHIN-SACH-FOOT

    HCPCS Level II L5100: Below-Knee Molded Socket with Shin and SACH Foot

    HCPCS-L5105-BELOW-KNEE-PLASTIC-SOCKET-SACH-FOOT

    HCPCS L5105: Below-Knee Plastic Socket Prosthesis with SACH Foot

    HCPCS-L5150-KNEE-DISARTICULATION-MOLDED-SOCKET-EXTERNAL-KNEE-SACH-FOOT

    HCPCS L5150: Knee Disarticulation Molded Socket with External Knee and SACH Foot

    HCPCS-L5160-KNEE-DISARTICULATION-MOLDED-SOCKET-BENT-KNEE-SACH-FOOT

    HCPCS Level II L5160: Knee Disarticulation Molded Socket, Bent Knee Configuration

    HCPCS-L5200-ABOVE-KNEE-MOLDED-SOCKET-SINGLE-AXIS-KNEE-SACH-FOOT

    HCPCS Level II L5200: Above-knee Prosthesis with Molded Socket and Single-axis Knee

    Showing 1–10 of 472

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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