Audiology Covered Softband/BAHA Procedure Code Details

Covered Softband/BAHA Procedure Code Details
Code	Description	PAR	Required PAR and Claim Modifier	Allowed Billing Provider Types	Allowed Rendering Provider Types
L8692	New. Auditory osseointegrated device, external sound processor, used without osseointegration, body worn, includes headband or other means of external attachment.	Always	UB	Physician, Pharmacy, Supply, Clinics, Osteopath, Audiologist.	Physician, Osteopath, Audiologist
L8691	Replacement. Auditory osseointegrated device, external sound processor.	Always	UB

Specific Non-Covered Benefits

·     Training or consultation provided by an Audiologist to an agency, facility, or other institution is not covered	·     The upgrading of an existing cochlear implant system or component if the existing unit is properly functioning is not covered	·     Hearing aids for adults (Hearing exams and evaluations are a benefit for adults only when a concurrent medical condition exists) are not covered
·     Hearing aid insurance is not covered	·     Any service not documented in the member's plan of care is not covered	·     Ear molds for the purpose of noise reduction or swimming are not covered
·     Any audiological services rendered by a non-licensed audiologist (except for licensed otolaryngologists and enrolled CHIP providers, are not covered