By Joan Sunderland – Senior Manager, Regional Reimbursement
Healthcare professionals often describe CPT coding as of one of the most confounding things to navigate in order to obtain insurance payment for their services. Questions often include a variation of the following:
- What codes should be included in a cochlear implant or bone conduction implant prior authorization request?
- What is the code for the initial fitting and MAPping of a bone conduction sound processor?
- What modifier(s) may be appropriate to append when multiple audiological services are performed during the same patient encounter?
In response to the need for a more comprehensive resource, Cochlear has established a Coding Support team. Just as Cochlear innovates and offers new products to support individuals with hearing loss, we offer a range of related resources to support professionals who may have coding-related questions. We recognize that providers are required to use their independent clinical judgment to render services, and the Coding Support team strives to provide timely and up-to-date coverage and reimbursement information to support patient access to Cochlear technology.
In addition to the Coding Support team, providers can access Otologic Management Services (OMS), which assists with surgical prior authorizations and appeals management related to Cochlear products, as well as a field-based team of health economics and reimbursement experts who focus on supporting practices as they expand services to include hearing implants.
As the global leader in implantable hearing solutions, Cochlear embraces the responsibility of providing a lifetime of support for professionals and recipients.
To contact the Cochlear Coding Support Area, please call 800-587-6910 or email your questions to firstname.lastname@example.org.
CPT and CPT material are copyrights of American Medical Association (AMA): CPT copyright 2020 American Medical Association, all rights reserved. CPT is a registered trademark of the American Medical Association. Information is provided as guidelines only to address the unique nature of implantable hearing solutions technology. This information does not constitute reimbursement or legal advice. Cochlear Americas makes no representation or warranty regarding this information or its completeness, accuracy, fitness for any purpose, timeliness, or that following these guidelines will result in any form of coverage or reimbursement from any insurance company or federal health care program payer. The information presented herein is subject to change at any time. This information cannot and does not contemplate all situations that a health care professional may encounter. To be sure that you have the most current and applicable information available for your unique circumstances, please consult your own experts and seek your own legal advice regarding your reimbursement and coding needs and the proper implementation of these guidelines. All products should be used according to their labeling. In all cases, services billed must be medically necessary, actually performed, and appropriately documented in the medical record.