Question
I realize tinnitus maskers and therapy are not routinely covered by insurance, but could you please tell me what CPT codes each could fall under? I work in an ENT setting. Thank You.
Answer
There is currently no specific CPT code for tinnitus intervention. Medicare and most other third party payers still consider tinnitus masking or other therapy "an experimental therapy" and do not cover it. There is a relatively new code, 92633, that audiologists can use for auditory rehabilitation, postlingual hearing loss, but it does NOT include tinnitus intervention.
Tinnitus devices, such as maskers, sound generators, Neuromonics, could be coded using Level II Health Care Procedure Coding System National Codes (HCPCS), which are required for reporting most medical services and supplies provided to Medicare and Medicaid patients and by most private payers. There is no specific code for a tinnitus device, but V5299 is for hearing service, miscellaneous. HCPCS instructions note that this code should be used only if a more specific code is unavailable.
One colleague reported to me that he used the HCPCS E code, E1399, which is for durable medical equipment, miscellaneous, with some limited success with a private insurance for a tinnitus device. They required a script and note from the medical doctor. If you work in an ENT office, they should be familiar with the codes for durable medical equipment.
For further information, you can go to: asha.org/Publications/leader/2009 and search for March 3, 2009 article titled "Bottom Line:Tinnitus Evaluation and Intervention"
Editor's Note: Christina Stocking presented a course on AudiologyOnline, "Setting up a Tinnitus Clinic." To register for this course, visit the AudiologyOnline continuing education library.
Christina Stocking is an audiologist and clinical assistant professor at the University at Buffalo. She has been working with tinnitus patients since 1998 at the University at Buffalo Speech and Hearing Clinic, where she was instrumental in establishing the tinnitus management program. At the university, Dr. Stocking has a busy tinnitus practice, teaches and supervises Au.D. students, and is active in clinical research. She has authored a chapter in The Consumer Guide on Tinnitus, ed. Richard Tyler, and frequently lectures on the evaluation and management of tinnitus.
