About this policy
CMS NCA document | source_status=Closed | review_type=New | public_comment_open=False | document_id=CAG-00107N
Coverage indications
The Centers for Medicare and Medicaid Services (CMS) has determined the following: The evidence is adequate to conclude that cochlear implantation is reasonable and necessary for treatment of bilateral pre-or-postlinguistic, sensorineural, moderate-to-profound hearing loss in individuals who demonstrate limited benefit from amplification. Limited benefit from amplification is defined by test scores of ≤ 40% correct in the best-aided listening condition on tape recorded tests of open-set sentence cognition. The evidence is sufficient to conclude that a cochlear implant is reasonable and necessary for individuals with hearing test scores of > 40 % and ≤ 60 % only when the provider is participating in and patients are enrolled in either an FDA-approved category B IDE clinical trial, a trial under the CMS Clinical Trial Policy, or a prospective, controlled comparative trial approved by CMS as consistent with the evidentiary requirements for National Coverage Analyses (See Appendix B) and meeting specific quality standards (See Appendix C).
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
Backwork has no codes on record for this policy. Check the source.