"Procedure Code" for hearing aid dispensing?

I am trying to get reimbursement for my hearing aids from Costco from Blue Cross Blue Shield. Initially they processed it as “hearing test” for $239, which they did not cover. I sent a message to BCBS and said that I’m asking for reimbursement for the aids, not the hearing test. They replied that it was processed as hearing test because “the receipt was illegible” and I need to submit “procedure codes” and “individual charges”. I replied to the message that the only charges were for the two aids, there was no other charges, and I am not sure what the “procedure codes” would be. Does anyone here know what code BCBS wants? Do they really need “procedure code” even if Costco did not charge for hearing tests or dispensing/adjustments?? I thought about calling Costco but their hearing center is closed already for the day.

OK, I googled and this may be what they want to know.

So is Charismo V5757? (hearing aid, digital, monaural, BTE)?

You want V5261 Hearing aid, digital, binaural, BTE. That’s for one pair of hearing aids. You’ll probably need a diagnosis code as well if you’re filling out a standard claim form. 389.10 is Sensorineural hearing loss, for example.

I also have BCBS, though I have not submitted anything yet. When I phoned for info, I was told there are 2 codes I need, and even though I purchased the HAs from Costco, I get the codes from my ENT office.

If what rasmus braun provided doesn’t work, phone your ENT office for the info.

Thanks rasmus_braun and Freedom. My husband remembered my fitter at Costco said that she would give me codes during the first visit. I’ll call Costco today and get them.

Just remember, what you need are medical codes, and Costco is not generally in the field of medicine. Sure the dispenser may have obtained the codes, and that would be great for you! My Costco doesn’t have them.

I not sure just knowing the codes is going to help you… tell Costco you want a clear legible correctly completed receipt. Can’t believe they are using hand written receipts.

— Updated —

I not sure just knowing the codes is going to help you… tell Costco you want a clear legible correctly completed receipt. Can’t believe they are using hand written receipts.

I called Costco this morning and they said they will fill out an invoice with codes that I can pick it up later today. Sounded like it was something they do routinely. Will let you guys know how it goes.

I have to ask, how are you getting BCBS to pay for your hearing aids? My policy clearly states hearing aids are excluded.

I guess our BCBS policy(through my husband’s work) must be different from yours. I know we have coverage because we called ahead and asked before I started the whole process of getting hearing aids.

A quick update. I picked up the invoice from Costco last night. Unlike the handwritten, triplicated receipt they gave me upon purchase everything is typed (Doc Jake, I dont know why they didn’t give this to me to begin with). It has description, model #, serial #, date of delivery of each aid complete with codes (V5261 as rasmus said). My fitter also added procedure codes for hearing test (92591) and sensorineural hearing loss (389.10) to memo. Freedom, if they didn’t give this to you when you got your aid, you should ask for it before filing insurance. I just faxed it to BCBS. Crossing my fingers to get some money back!

The difference may also be state law. Here in RI, we have a state mandate, all insurance must cover hearing aids, a minimum of $700 per ear, every 3 years. Of course, no one offers MORE than the $700. :stuck_out_tongue: AND as the mandate didn’t specify, the insurance companies have interpreted the mandate to mean AFTER you meet your deductible. :rolleyes:

Further, our RI mandate only applies to insurance companies BASED here in RI. As a result, BCBS is the only company impacted by this. Sure we have Tufts and United Healthcare, and a few others who offer coverage here in RI: but they are not BASED here, so they do not have to comply with the law; and they don’t. No coverage for hHAs on their policies.

Freedom, that’s good to know! I know it was directed toward Patricia, but thanks for the info. All states should be doing that :slight_smile:

Frankly, I think it’s unconscionable that insurance companies everywhere aren’t required to cover a least part of the cost of hearing aids and audiology services. Especially when you consider some of the things that they do cover which have far less impact on a person’s health and general well being than the ability to communicate.


Just wanted to update…took it for a while because BCBS messed up, but I finally got reimbursed about 70% of the HA cost last week. Thanks everyone for your help!