Summary & Overview
HCPCS V5247: Digitally Programmable Analog Monaural BTE Hearing Aid
HCPCS Level II code V5247 denotes a monaural, behind-the-ear (BTE), digitally programmable analog hearing aid. This code is used when billing for the provision of a single BTE analog hearing instrument that supports digital programmability. Nationally, provision and coverage of hearing aids have significant implications for access to auditory rehabilitation, patient quality of life, and durable medical equipment (DME) benefit management.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what V5247 represents, where the device is typically supplied and fitted, and which clinical settings use this code. The publication also outlines the kinds of benchmarks and policy considerations typically associated with hearing aid codes — including coverage determination, site-of-service expectations, and billing practice alignment — and notes where input data was not provided.
This summary prepares clinicians, billing staff, and policy analysts to interpret V5247 in the context of equipment provisioning and payer rules. Data not available in the input is clearly identified; the content focuses on the code definition, clinical context, and the national payer landscape relevant to hearing aid billing.
Billing Code Overview
HCPCS Level II code V5247 describes a hearing aid, digitally programmable analog, monaural, behind-the-ear (BTE) device. This code covers a single-ear, digitally programmable analog hearing instrument designed for placement behind the ear and connected to an earmold or earpiece.
Service type: Durable medical equipment — hearing aid fitting and device provision
Typical site of service: Audiology clinic, ENT office, or specialized hearing aid dispensary
Clinical & Coding Specifications
Clinical Context
A 72-year-old patient with progressive bilateral sensorineural hearing loss presents to an audiology clinic for hearing evaluation and management. After pure-tone audiometry and speech discrimination testing confirm moderate-to-severe unilateral asymmetry with one ear meeting candidacy criteria for amplification, the audiologist or otolaryngologist documents benefit from a behind-the-ear (BTE) digitally programmable analog hearing aid for the affected ear. The patient selects a monaural device described by HCPCS Level II code V5247 (Hearing aid, digitally programmable analog, monaural, BTE). Clinical workflow includes device selection and trial, verification with real-ear measurements or coupler measurements, device programming/adjustment, patient counseling on use and care, and scheduling follow-up for fitting optimization. Billing occurs at device provision with applicable modifiers for laterality, supplier, or service circumstances and may be accompanied by diagnostic evaluation CPT codes billed separately by the audiologist or physician for the testing and fitting services.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no circumstance-specific modifier applies |