Aetna considers aural rehabilitation medically necessary as speech therapy for members with hearing impairments and after placement of a cochlear implant.
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.
CPT Codes / HCPCS Codes / ICD-9 Codes
CPT codes covered if selection criteria are met:
92626
+ 92627
92630
92633
Other CPT codes related to the CPB:
69930
Other HCPCS codes related to the CPB:
L8614 - L8624
Cochlear device/system/supplies
ICD-9 codes covered if selection criteria are met:
385.00 - 385.9
Other disorders of middle ear and mastoid
386.00 - 386.04
Meniere's disease
387.0 - 387.9
Otosclerosis
388.00 - 388.9
Other disorders of ear
389.00 - 389.99
Hearing loss
Other ICD-9 codes related to the CPB:
V41.2
Problems with hearing
V57.3
Speech therapy
The above policy is based on the following references:
Lantsov AA, Koroleva IV, Pudov VI. Rehabilitation and assessment of aural-oral speech development in children with cochlear implants. Vestn Otorinolaringol. 2000;(3):6-12.
Danermark BD. Hearing impairment, emotions and audiological rehabilitation: A sociological perspective. Scand Audiol Suppl. 1998;49:125-131.
Wazen JJ, Wright R, Hatfield RB, et al. Auricular rehabilitation with bone-anchored titanium implants. Laryngoscope. 1999;109(4):523-527.
Tomaski SM, Grundfast KM. A stepwise approach to the diagnosis and treatment of hereditary hearing loss. Pediatr Clin North Am. 1999;46(1):35-48.
Jankowski R, Pialoux R, Labaeye P, et al. Bone anchored hearing aid (BAHA): Clinical evaluation. Ann Otolaryngol Chir Cervicofac. 1998;115(6):315-320.
Karlsson AK, Rosenhall U. Aural rehabilitation in the elderly: Supply of hearing aids related to measured need and self-assessed hearing problems. Scand Audiol. 1998;27(3):153-160.
Sykes S, Tucker D, Herr D. Aural rehabilitation and graduate audiology programs. J Am Acad Audiol. 1997;8(5):314-321.
American Speech-Language-Hearing Association (ASHA). Aural rehabilitation. Information for the Public. Rockville, MD: ASHA; 2004. Available at: http://www.asha.org/public/hearing/treatment/gen_aur_rehab.htm. Accessed January 22, 2004.
Tobey EA, Devous MD Sr, Buckley K, et al. Pharmacological enhancement of aural habilitation in adult cochlear implant users. Ear Hear. 2005;26(4 Suppl):45S-56S.
Hawkins DB. Effectiveness of counseling-based adult group aural rehabilitation programs: A systematic review of the evidence. J Am Acad Audiol. 2005;16(7):485-493.
Boothroyd A. Adult aural rehabilitation: What is it and does it work? Trends Amplif. 2007;11(2):63-71.
Sweetow RW, Sabes JH. Technologic advances in aural rehabilitation: Applications and innovative methods of service delivery. Trends Amplif. 2007;11(2):101-111.
Li J, Xi X, Hong M, et al. Study of aural rehabilitation in post-lingual deafened patients with multi-channel cochlear implant. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2010;24(13):580-582.
Copyright Aetna Inc. All rights reserved. Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract. Aetna does not provide health care services and, therefore, cannot guarantee any results or outcomes. Participating providers are independent contractors in private practice and are neither employees nor agents of Aetna or its affiliates. Treating providers are solely responsible for medical advice and treatment of members. This Clinical Policy Bulletin may be updated and therefore is subject to change.
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