Summary & Overview
HCPCS Level II V5290: Assistive Listening Device, Transmitter Microphone
HCPCS Level II code V5290 covers an assistive listening device transmitter microphone used to support individuals with hearing impairment by transmitting audio to hearing assistive systems. Nationally, this code matters because it identifies a common category of durable medical equipment that intersects audiology, outpatient care, and long-term care settings, influencing coverage determinations and device provisioning across payers. Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn what the code represents, typical sites of service, and how it is used in billing for assistive listening equipment. The publication also outlines benchmarking elements, payer coverage patterns, and relevant clinical context for device use, enabling billing staff and policy analysts to understand where this code sits within durable medical equipment and audiology service lines. Data not available in the input for detailed coverage rules, associated taxonomies, and ICD-10 mappings is noted where applicable.
Billing Code Overview
HCPCS Level II code V5290 denotes an assistive listening device, transmitter microphone, any type. This code represents devices used to transmit audio to assistive listening systems, typically for individuals with hearing impairment.
Service type: Durable medical equipment / assistive listening device.
Typical site of service: Outpatient clinics, audiology clinics, specialty hearing centers, long-term care facilities, and other ambulatory settings where assistive listening devices are provided or dispensed.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with conductive hearing loss attends an audiology clinic for amplification support in a public speaking or classroom environment. The audiologist evaluates the patient and determines that an assistive listening system with a transmitter microphone will improve signal-to-noise ratio for speech understanding during conversation, lectures, or worship services. The device is dispensed either by the audiology clinic or durable medical equipment supplier after demonstration and fitting. Typical workflow: patient assessment (history, pure-tone audiometry, speech-in-noise testing), selection of an assistive listening transmitter microphone system, verification of device function and patient education on use and maintenance, documentation of medical necessity and device configuration, and billing for the assistive listening device using code V5290.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When work required is substantially greater than typically required for device fitting or counseling beyond standard time and effort |
23 | Unusual anesthesia |