Download Cochlear-Implants

Cochlear Implants
Revised: 03-05-2015
A cochlear implant is a prosthetic device that may help provide hearing to those who have profound deafness and would receive
little or no benefits from hearing aids.
Criteria for cochlear implantation and programming
MHCP will consider payment for cochlear implantation and programming when the following criteria are met:
Authorization
All cochlear implant purchases and replacement devices require authorization.
Criteria for Adults
Adults age 18 and older must have all of the following:
 Diagnosis of moderate to profound sensorineural deafness that cannot be mitigated by use of a hearing aid in patients whose
auditory cranial nerves are stimulable
 Cognitive ability to use auditory clues and a willingness to undergo an extended program of rehabilitation
 Freedom from chronic middle ear infection, an accessible cochlear lumen that is structurally suited to implantation, and
freedom from lesions in the auditory nerve and acoustic areas of the central nervous system
 No contraindications to surgery
Criteria for Children
Children must be at least 12 months of age and must have all of the following:
 Diagnosis of bilateral severe to profound sensorineural deafness with little or no benefit from a hearing (or vibrotactile) aid in
patients whose auditory nerves are stimulable
 Freedom from middle ear infection and accessible cochlear lumen that is structurally suited to implantation, and freedom from
lesions in the auditory nerve and acoustic area of the central nervous system
 No contraindication to the implant, including those described in the product’s FDA approved package insert
The child must be teachable and trainable so he or she is able to participate in the extensive post-operative rehabilitation .
Required documentation
Claims must include the following:
 Diagnosis with the appropriate ICD code
 Medical history pertaining to the cochlear implant
 Reports
 Audiology: including the final report from any pre-cochlear implant hearing training (children)
 Speech: including test results of age-appropriate closed-set work identification tasks and other tests
 Psychology: including a clear statement as to the individual’s cognitive ability to participate in the post-surgical
rehabilitation program
Billing
Refer to the following table for billing codes and provider types that may provide and bill for the services listed.
HCPCS
Description
Provider Type
Codes
Cochlear Implant Service
L8614
Cochlear device, includes all internal and external components
Hospital, physician
Replacement cochlear components
L8615
Headset/headpiece for use with cochlear implant device, replacement
Hospital, physician,
audiologist, hearing
L8616
Microphone for use with cochlear implant device, replacement
instrument dispenser,
L8617
Transmitting coil for use with cochlear implant device,
medical supplier
replacement
L8618
Transmitter cable for use with cochlear implant device, replacement
L8619
Cochlear implant, external speech processor and controller, integrated system,
replacement
L8627
Cochlear implant, external speech processor, component, replacement
L8628
Cochlear implant, external controller component, replacement
L8629
Transmitting coil and cable, integrated, for use with cochlear implant device,
replacement
Batteries
L8621
L8622
L8623
L8624
Zinc air battery for use with cochlear implant devices, replacement
Alkaline battery for use with cochlear implant devices, any size, replacement, each
Lithium ion battery for use with cochlear implant device speech processor, other
than ear level, replacement, each
Lithium ion battery for use with cochlear implement device speech processor, ear
level, replacement, each