Summary & Overview
HCPCS V5230: Hearing Aid, Contralateral Routing System, Binaural, Glasses
HCPCS Level II code V5230 identifies a glasses-mounted contralateral routing system (CRS) hearing aid configured for binaural use. The code denotes a specialized durable medical device that routes sound from the impaired side to the better-hearing ear while integrating amplification into eyeglass frames. Nationally, this device category is relevant for coverage determinations, durable medical equipment (DME) policy, and benefit design affecting patients with unilateral or asymmetric hearing loss.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for use of CRS glasses, common sites of service where devices are fitted and dispensed, and the kinds of documentation typically relevant for medical necessity determinations. The publication also summarizes available benchmarks and policy considerations that influence coverage and reimbursement for specialized hearing assistive devices, and highlights procedural and billing considerations tied to HCPCS coding for durable medical equipment.
The content aims to help clinical coders, billing staff, and policy analysts understand what HCPCS Level II code V5230 represents, how it fits into DME workflows, and where to look for coverage guidance and documentation expectations. Data not available in the input for payer-specific rates, taxonomies, and ICD-10 pairings is noted in other sections.
Billing Code Overview
HCPCS Level II code V5230 describes a hearing aid, contralateral routing system, binaural, glasses. This device integrates hearing amplification and contralateral routing technology into a glasses-mounted hearing aid designed to provide binaural auditory support for patients with unilateral hearing limitations by routing sound to the contralateral ear.
Service type: Durable medical equipment — hearing aid/assistive listening device.
Typical site of service: Outpatient clinic, audiology practice, hearing aid dispenser office, or other ambulatory care settings.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with asymmetric sensorineural hearing loss and poor sound localization presents to an audiology clinic. The patient has a functioning hearing aid in the better ear but limited benefit in the poorer ear due to non-serviceable hearing on that side. After audiometric evaluation, speech-in-noise testing, and a candidacy assessment, the audiologist recommends a contralateral routing of signal (CROS) system integrated into eyeglass frames to deliver sound from the poorer ear side to the better-hearing ear. The typical workflow includes referral or ordering by an otolaryngologist or audiologist, comprehensive audiometric testing (pure tone audiometry, speech discrimination, real-ear measures as applicable), device selection and verification, frame fitting and device programming, patient education on use and care, and follow-up visits for adjustments. The device described by billing code V5230 (hearing aid, contralateral routing system, binaural, glasses) is supplied via the durable medical equipment channel and dispensed in an outpatient clinic, audiology office, or hearing aid dispenser location. Typical sites of service are outpatient hospital clinics, freestanding audiology offices, and retail hearing aid offices that provide medical device dispensing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no modifier applies |