V5243 Hearing aid, monaural, itc
Also known as: monaural ITC, in-the-canal aid
Monaural in-the-canal hearing aid (ITC style) for unilateral hearing loss with device partially inserted in ear canal.
In Plain Language
single hearing aid partially in ear canal; partially-inserted ear device
Clinical Context
Used for unilateral mild to moderate hearing loss with in-the-canal placement providing balance between cosmetics and ease of use.
RVU Information
CPT V5243 does not have a physician work RVU assigned by CMS. This is typical for supply, drug, and equipment codes — reimbursement is based on Average Sales Price (ASP), fee schedules, or payer contracts rather than the RVU system.
Billing & Documentation
V-codes cover vision services, supplies, and equipment including lenses, frames, and hearing aids. A valid prescription from an authorized provider is required. Document the specific product dispensed, measurements, and clinical indication.
Specialties
Frequently Asked Questions
What is CPT code V5243?
CPT V5243 (Hearing aid, monaural, itc) is a V Codes (Vision) code. Monaural in-the-canal hearing aid (ITC style) for unilateral hearing loss with device partially inserted in ear canal.
Does Medicare cover V5243?
Medicare coverage for V5243 depends on medical necessity and applicable Local Coverage Determinations (LCDs). Used for unilateral mild to moderate hearing loss with in-the-canal placement providing balance between cosmetics and ease of use. A physician order is typically required.
When is CPT V5243 used?
Used for unilateral mild to moderate hearing loss with in-the-canal placement providing balance between cosmetics and ease of use.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.