Wiki Audiology DME question

medihedgie

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Is it possible to use two CPT codes for a durable medical device? The reason I ask is because we initially coded V5257 for a Cochlear Baha osseointegrated device thinking that Aetna would not cover the CPT code L8692. In theory the processor could be considered a digital behind the ear hearing aid when it is worn on a headband. And since the child is too young for the surgery and we are not a surgical facility we could not code L8690.

I do not recall why we decided this and didn?t initially code L8962 and L9900. Unfortunately, the parents only received about $500 although they were told they had a $1200 benefit. Parents are just trying to get close to the $1200 and don't understand what is going on. I wrote a LMN and an appeal asking for additional coverage. Parents asked if it was possible to resubmit with the code L8692. If we do, what is the process? Would Aetna ask for the $500 back? Isn't there a possibility that they do not cover L8692 or would reimburse less than they did for the V5257?
Baha Softband
L8692 Auditory osseointegrated device, external sound processor, used without osseointegration, body worn, includes headband or other means of external attachment (Softband with sound processor)

Baha Softband system.
L9900 Baha Softband headband (replacement headband only)

Can anyone either answer or give me direction to who might be able to help me please? Thank You!
 
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