Medicare AdvantageCoverageMedium impact
MA11.049g, Bone-Anchored (Osseointegrated) Hearing Aids and Implantable Middle Ear Hearing Aids
Independence Blue Cross·Audiology, ENT (Ear, Nose & Throat), Neurosurgery·Medical Policy
Effective date
May 28, 2025
We identified it
Jun 19, 2026
Summary
Independence Blue Cross reissued MA policy 11.049h (effective 05/28/2025) regarding bone-anchored osseointegrated hearing aids and implantable middle ear hearing aids. The policy confirms continued coverage for bone-anchored hearing aids meeting specific audiologic criteria for conductive/mixed hearing loss and single-sided sensorineural deafness, while implantable middle ear devices remain non-covered (experimental/investigational). External sound processors without osseointegration (L8692) are explicitly not covered.
Action Required
By 05/28/2025: Billing team must update claims processing rules to reflect the reissued policy MA11.049h. Specifically: (1) Verify that claims for CPT codes 69714, 69716, 69717 and HCPCS codes L8618, L8624, L8625, L8690 are only approved when submitted with appropriate ICD-10 diagnosis codes (H90.0, H90.11, H90.12, H90.2, H90.41, H90.42) AND documented evidence of meeting audiologic criteria (bone-conduction thresholds and symmetry requirements); (2) Ensure prior authorization system requires confirmation that bone-anchored device is FDA-approved; (3) Add hard-stop rule to deny all claims for L8692 (external sound processor without osseointegration); (4) Flag all claims for implantable middle ear devices (code not specified in policy) for denial with communication that device is experimental/investigational and non-covered. Update billing software, prior authorization templates, and denial letter templates. Route this update to billing team and credentialing staff. Failure to implement these rules will result in improper claim approvals and potential overpayments.