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19.2.4 Bone-Anchored Hearing Aid (BAHA)
A bone-anchored hearing aid (BAHA) may be reimbursed by the CSHCN Services Program for clients who are 5 years of age or older and who meet the medical necessity criteria. The following procedure codes may be reimbursed with prior authorization:
Procedure codes L8691 and L8692 will be denied as part of another service when billed by any provider for the same date of service as L8690.
Replacement batteries for the BAHA may be reimbursed using procedure code V5266 and do not require authorization. Replacement batteries are limited to clients with a previously-billed hearing device. Replacement batteries for clients who did not receive the hearing device under CSHCN Services Program benefits may be reimbursed on appeal with a physician's statement documenting medical necessity.
The BAHA is Food and Drug Administration (FDA)-approved for clients who are 5 years of age or older. Clients who are younger than 5 years of age do not have sufficient bone density for implantation of the device.
The following provider types may be reimbursed for the BAHA device and services:
• Physicians
•Audiologists
•Home health DME
•Medical and DME supplier
•Custom DME providers
•Ambulatory surgical centers (freestanding/independent and hospital-based)
•Hospitals
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