Billing a hearing aid upgrade


Medina, OH
Best answers
Does anyone have any insight into hearing aid upgrade billing? We are currently following the Medicare guidelines for upgrade billing including signature of an ABN/Waiver. The current DME guidelines state to bill with GA/GK modifier with the covered code and the upgraded code. The problem is the hearing aid codes are limited to location of the aid, not the technology that is in them. Therefore we are billing the same HCPCS code for the covered aids as we are for the upgraded aids. There are several theories about adding RT/LT modifier and billing monaural codes for the covered aid, then billing the binaural code for the upgraded item. The insurance companies are processing these claims but paying on the line item we billed as upgrade since it's the same code. Any insight is appreciated.