Summary & Overview
HCPCS Level II V5248: Hearing Aid, Analog, Binaural, CIC
HCPCS Level II code V5248 denotes an analog, binaural, completely-in-canal (CIC) hearing aid device. Nationally, this code is used to bill for the provision and fitting of two in-ear analog hearing aids for patients with bilateral hearing loss. The code is relevant for durable medical equipment billing, audiology services, and outpatient device dispensing.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for CIC analog hearing aids, payer coverage considerations, and typical settings for service delivery. The publication highlights common billing modifiers and procedural context where available, outlines expected service lines, and summarizes typical sites of service for device provision.
This summary is intended for clinicians, billing specialists, and policy analysts seeking a focused reference on the code’s clinical meaning, billing context, and payer coverage environment at the national level. Data not available in the input is identified where applicable.
Billing Code Overview
HCPCS Level II code V5248 describes a hearing aid, analog, binaural, cic. This code denotes provision of two analog completely-in-canal (CIC) hearing aids, intended to treat bilateral hearing loss with discreet, in-ear amplification.
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Service type: Durable medical device provision and fitting of analog binaural CIC hearing aids
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Typical site of service: Audiology clinic, hearing aid dispenser office, or outpatient specialty clinic
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with progressive bilateral sensorineural hearing loss presents to an audiology clinic for hearing evaluation and device fitting. Otoscopic exam is unremarkable; pure-tone audiometry and speech discrimination testing confirm a moderate-to-severe symmetric sensorineural hearing loss appropriate for amplification. The clinician recommends an analog, binaural, completely-in-canal (CIC) hearing aid using billing code V5248.
The clinical workflow: the patient undergoes diagnostic audiometry and counseling, selection of the CIC analog device, ear impressions if a custom shell is required, device programming and verification in the clinic, real-ear or aided sound field checks as indicated, patient education on insertion/removal, battery use, maintenance, and scheduling follow-up for fine-tuning and warranty registration. Documentation includes device model, serial numbers, justification for binaural amplification, and comparison of unaided versus aided speech scores to support medical necessity.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no modifier applies |
22 |