HCPCS Code V5267: Hearing aid or assistive listening device, supplies, or accessories, NOS

Ensure accurate billing of HCPCS Code V5267 with guidance on documentation, modifiers, and payer requirements.

## **What is HCPCS code V5267?** HCPCS code V5267 is used to report unspecified hearing aid or assistive listening device supplies and accessories. It serves as a catch-all code when a needed part, such as a receiver, specialty cord, ear-level component, or other hearing device or listening device supplies/accessories, does not have a more specific HCPCS code. Because it is an unspecified code, payers usually require a detailed description of the item on the claim, including the manufacturer, model, part number, and quantity. Coverage is often reviewed on a case-by-case basis. V5267 is frequently included in hearing services code sets but is subject to payer-specific limitations. For example, some Medicaid programs restrict its use to specific items, such as rechargeable batteries or select replacement parts, and may require prior authorization or documentation beyond routine dispensing notes. Before billing V5267, providers should always confirm what items are eligible for coverage under the applicable payer’s policy.

## **Documentation requirements** Complete and accurate records are critical for N.O.S. codes. Documentation must include: - A detailed description of the item being dispensed. - The manufacturer's name, model or part number, and the quantity provided. - Clinical rationale establishing the medical necessity of the item for the patient's specific hearing aid or assistive listening device. The date of service and provider signature, ensuring all records align with payer rules.

## **Billing requirements for V5267** Billing for V5267 typically follows these rules: - Report 1 per accessory or supply provided - Use RT (right ear) or LT (left ear) when billing for side-specific accessories ONLY if the payers require them (not all payers insist on side modifiers for accessory codes; policies vary) - Traditionally, Medicare does not cover hearing aids or related supplies, including v5267. However, some commercial payers and Medicaid programs may allow reimbursement, depending on their specific policies. - Always include the item description and supporting documentation, since payers review these carefully for NOS codes.

## **Other relevant codes** Other HCPCS, CPT, or ICD-10-CM codes that may relate or be needed in conjunction with V5267 include: - **HCPCS V5298** – Hearing aid, new technology - **HCPCS V5299** – Hearing service, miscellaneous - **CPT 92592** – Hearing aid check; monaural - **CPT 92593** – Hearing aid check; binaural - **ICD-10-CM Z46.1** – Encounter for fitting and adjustment of hearing aid

Frequently asked questions

V5267 should be used only when a more specific HCPCS code cannot describe a hearing aid, assistive listening device, or accessory. It applies to custom or non-standard parts such as unique connectors or specialized ear mold inserts. Standard items, such as disposable batteries or basic ear molds, usually have their own dedicated codes.

Claims should include detailed documentation such as the manufacturer’s name, model or part number, and an invoice or catalog page showing the wholesale cost. Records must also explain why the item is medically necessary for the patient’s device. Some payers, especially Medicaid programs, may require prior authorization, such as a TAR or SAR.

Reimbursement for V5267 varies by payer and is not standardized. It may be based on a contracted fee schedule, a cost-plus formula, or the lesser of the billed charge and the payer’s allowable amount. Providers must include cost details, proper modifiers, and all required documentation to support payment.