Summary & Overview
HCPCS V5262: Hearing Aid, Disposable, Monaural
HCPCS Level II code V5262 designates a disposable, monaural hearing aid — a single-ear, short-term amplification device. This code matters nationally as it identifies a low-cost, often single-use option for patients with temporary or situational hearing needs and affects coverage decisions, supply chain management, and outpatient dispensing workflows.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code's clinical role and common sites of service, plus national-level considerations for payer coverage policies, billing practice benchmarks, and implications for durable medical equipment suppliers and audiology providers.
The publication outlines typical reimbursement contexts and the policy and coding considerations that influence use of V5262, including how disposable hearing aids fit within broader hearing device coverage policies and patient access. It also summarizes available benchmarks for service lines and payer coverage patterns where available, and highlights where data is not provided. The content is intended to inform billing staff, audiology clinicians, durable medical equipment suppliers, and policy analysts about the operational and policy relevance of HCPCS Level II code V5262.
Billing Code Overview
HCPCS Level II code V5262 describes a hearing aid, disposable, any type, monaural. This code represents a single-ear, non-reusable hearing amplification device intended for short-term or disposable use.
Service Type: Durable medical device — hearing aid (disposable), monaural
Typical Site of Service: Retail clinic, audiology clinic, durable medical equipment supplier, or other outpatient setting where hearing aids are dispensed or sold
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 72-year-old patient with progressive bilateral sensorineural hearing loss presents to an audiology clinic for hearing rehabilitation. The audiologist performs a hearing assessment, determines the patient has mild-to-moderate hearing loss in one ear where a low-cost, single-use solution is appropriate, and fits a disposable, monaural hearing aid covered under durable medical equipment or retail purchase pathways. The workflow includes: pre-visit triage, otoscopic exam to rule out cerumen impaction, threshold audiometry and speech testing, device selection and demonstration of the disposable hearing aid (billing code V5262), patient education on insertion, battery use, and expected device lifetime, documentation of medical necessity and informed consent, and dispensing the device with instructions for follow-up or referral to otolaryngology if complications or inadequate benefit occur. Typical site of service is an outpatient audiology clinic, hearing aid dispensary, or retail hearing center that dispenses over-the-counter or disposable monaural hearing aids.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unspecified or default modifier | Use when no specific modifier from the set applies and payer requires a default two-character modifier. |