Auditory Osseointegrated Implants* 

Medical Policy: 01.01.14 
Original Effective Date: July 2006 
Reviewed: July 2008 
Revised: July 2008 

This policy applies to all products unless specific contract limitations, exclusions or exceptions apply. Please refer to the member's coverage manual for benefit availability. Managed care guidelines related to referral authorization, and precertification of inpatient hospitalization, home health, home infusion and hospice services apply.

Description: 

Auditory osseointegrated implants, such as the bone anchored hearing device or BAHA®, transmit sound vibrations through the mastoid process of the temporal bone to the cochlea via a skin-penetrating titanium implant. These prosthetic devices replace the function of the middle ear in persons with conductive or mixed conductive and sensorineural hearing loss. They are indicated only when air-conduction hearing aids are medically inappropriate or cannot be utilized.

Policy: 

Auditory osseointegrated implants may be considered a medically necessary prosthetic device for persons with a unilateral or bilateral conductive or mixed conductive and sensorineural hearing loss with a pure tone average bone conduction threshold of up to 70 dB and a speech discrimination score better than 60 % who have any of the following conditions in which an air conduction device is not indicated:

  • Congenital or surgically-induced malformations of the external ear or middle ear
  • Tumors of the external ear
  • Tumors of the tympanic cavity
  • Otosclerosis in patients who are not suitable candidates for stapedectomy
  • Severe chronic otitis externa or otitis media
  • Dermatitis of the external ear, including hypersensitivity reactions to the earmolds used in conduction hearing aids

Auditory osseointegrated implants are considered not medically necessary for other indications including, but not limited to, pure sensorineural hearing loss which affects the detection and neural integration of sound in the inner ear.

Prior approval is recommended. Submit a prior approval now.


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Procedure Codes and Billing Guidelines: 

  • To report provider services, use appropriate CPT** codes, Alpha Numeric (HCPCS level 2 ) codes, Revenue codes, and/or ICD-9-CM diagnostic codes.
  • CPT 69710 Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone. This code represents the AudiantTM bone conductor, a type of electromagnetic bone conduction hearing device. While this product is no longer actively marketed, patients with existing AudiantTM devices may require replacement, removal, or repair.
  • CPT 69711 Removal or repair of electromagnetic bone conduction hearing in temporal bone. This code also represents the AudiantTM  bone conductor.
  • CPT 69714 Implantation, osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; without mastoidectomy.
  • CPT 69715  Implantation, osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; with mastoidectomy.
  • CPT 69717 Replacement (including removal of existing device), osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; without mastoidectomy.
  • CPT 69718 Replacement (including removal of existing device), osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; with mastoidectomy.     

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Selected References: 

  • Snik AF, Mylanus EA, Cremers CW, The bone-anchored hearing aid compared with conventional hearing aids. Audiologic results and the patients's opinions. Otolaryngol Clin North Am 1995; 28(1):73-83.
  • Wazen JJ, Caruso M, Tjellstrom A. Long-term results with titanium bone anchored hearing aid: the U.S. experience. Am J Otol 1998; 19(6):737-41.
  • Van der Pouw CT, Snik AF, Cremers CW. The BAHA HC200/300 in comparison with conventional bone conduction hearing aids. Clin Otolaryngol 1999; 24(3):171-6.
  • Granstrom G, Tjellstrom A. The bone-anchored hearing aid (BAHA) in children with auricular malformations. Ear Nose Throat J 1997; 76(4):238-47, passim.
  • Tjellstrom A, Hakansson B, Granstrom G. Bone-anchored hearing aids: current status in adults and children. Otolaryngol Clin North Am. 2001 Apr;34(2):337-64.
  • Snik AF, Mylanus EA, Cremers CW. The bone-anchored hearing aid: a solution for previously unresolved otologic problems. Otolaryngol Clin North Am. 2001 Apr;34(2):365-72.
  • Raz Y, Lustig L. Surgical management of conductive hearing loss in children. Otolaryngol Clin North Am. 2002 Aug;35(4):853-75.
  • Baguley DM, Bird J, Humphriss RL et al. The evidence base for the application of contralateral bone anchored hearing aids in acquired unilateral sensorineural hearing loss in adults. Clin Otolaryngol. 2006 Feb;31(1):6-14.
  • Hol MK, Snik AF, Mylanus EA et al. Long-term results of none-anchored hearing aid recipients who had previously used air-conduction hearing aids. Arch Otolaryngol Head Neck Surg. 2005;131(4):321-325.
  • Johnson CE, Danhauer JL, Reith AC et al. A systematic review of the non acoustic benefits of bone-anchored hearing AIDS. Ear Hear. 2006;27(6):703-713.
  • Priwin C, Jonsson R, Hultcrantz M et al. BAHA in children and adolescents with unilateral or bilateral conductive hearing loss: a study of outcome. Int J Pediatr Otorhinolaryngol. 2007;71(1):135-145. 

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New information or technology that would be relevant for Wellmark to consider when this policy is next reviewed may be submitted to:

Wellmark Blue Cross and Blue Shield
Medical Policy Analyst
Station 304
636 Grand Ave
Des Moines, Iowa 50309

*Prior approval is recommended for this policy.

**Current Procedural Terminology © 2009 American Medical Association. All Rights Reserved.

Wellmark medical policies address the complex issue of technology assessment of new and emerging treatments, devices, drugs, etc.   They are developed to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. Wellmark medical policies contain only a partial, general description of plan or program benefits and do not constitute a contract. Wellmark 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 Wellmark or its affiliates. Treating providers are solely responsible for medical advice and treatment of members. Our medical policies may be updated and therefore are subject to change without notice.