Summary & Overview
HCPCS V5274: Assistive Listening Device, Not Otherwise Specified
HCPCS Level II code V5274 identifies an assistive listening device (not otherwise specified), covering a range of devices used to enhance auditory access for patients with hearing impairment. Nationally, billing for assistive listening devices affects durable medical equipment workflows, audiology providers, and payers managing coverage for sensory-assistive technologies. The code is relevant for providers who supply or fit non-implantable listening equipment and for payers assessing benefit design for hearing-related durable medical equipment.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what V5274 represents, typical sites of service, and the service type. The publication also summarizes common modifiers associated with the code and highlights where data is not provided in the input.
The report is designed to inform billing and revenue-cycle staff, audiology and DME suppliers, and payer policy teams about the code’s clinical context and administrative considerations. It provides benchmarks and policy-oriented context where available, and flags gaps where input data is missing. National in scope, the discussion focuses on administrative use of the code rather than clinical treatment recommendations.
Billing Code Overview
HCPCS Level II code V5274 denotes an assistive listening device, not otherwise specified. This code represents devices intended to improve auditory access for patients with hearing impairment by amplifying or clarifying sound.
Service type: Assistive listening device supply and provision
Typical site of service: Outpatient clinic, durable medical equipment supplier, audiology or hearing services setting, and other non-acute care locations
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with sensorineural hearing loss or situational hearing difficulty (for example, in a classroom, theater, or church) who requires an assistive listening device to improve access to sound. The patient presents to an audiology or otolaryngology clinic for evaluation. The audiologist or hearing specialist performs history, pure-tone and speech audiometry, and verifies that a personal hearing aid is insufficient or not appropriate for a specific listening situation. The team selects an assistive listening device (V5274) such as a personal FM/DM system, loop-compatible receiver, or an amplified listening device. The device is fitted, programmed or paired with the transmitter, and the patient receives brief training on use, maintenance, and troubleshooting. Documentation includes the audiologic assessment, device model and serial number, medical necessity rationale, patient education, and any follow-up or trial plan. Typical sites of service are outpatient audiology clinics, otolaryngology offices, hearing aid centers, schools, and community health settings where audiology services are delivered.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when substantially greater effort or complexity is required to fit or adapt the device beyond usual service. |