Aetna considers aural rehabilitation medically necessary as speech therapy for members with hearing impairments and after placement of a cochlear implant.
See also CPB 0013 - Cochlear Implants and Auditory Brainstem Implants.
An aural rehabilitation program generally starts as soon as a patient is identified as having a hearing impairment, or after placement of a cochlear implant. The patient is taught to speak, to adjust to a hearing aid or cochlear implant, and to look to a speaker's mouth and face to better comprehend what is being said. The parent or other caregiver is taught to treat the patient normally, to talk to the patient, and interact with him/her as though there were no impairment. The rehabilitation program following implantation of a cochlear implant usually consists of 6 to 10 sessions that last approximately 2.5 hours each.
The above policy is based on the following references:
|CPT codes covered if selection criteria are met:
||Evaluation of auditory rehabilitation status; first hour
|| each additional 15 minutes
||Auditory rehabilitation; pre-lingual hearing loss
|| post-lingual hearing loss
|Other CPT codes related to the CPB:
||Cochlear device implantation, with or without mastoidectomy
|Other HCPCS codes related to the CPB:
|L8614 - L8624
|ICD-9 codes covered if selection criteria are met:
|385.00 - 385.9
||Other disorders of middle ear and mastoid
|386.00 - 386.04
|387.0 - 387.9
|388.00 - 388.9
||Other disorders of ear
|389.00 - 389.99
|Other ICD-9 codes related to the CPB:
||Problems with hearing
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