Bone Conduction
by Jamie Schwartz

The Baha® System can help your pediatric patients with mixed or conductive hearing loss

February 8, 2018
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For pediatric patients with mixed or conductive hearing loss (MHL/CHL) a bone conduction hearing solution may be the best treatment option. Through bone conduction, sound is delivered naturally through the bone directly to the cochlea, independent of the outer and middle ear.

The Cochlear™ Baha® System leverages this natural process by amplifying sound signals, converting them into vibrations and transmitting them to the cochlea. Many hearing care professionals agree that for MHL and CHL the Baha System is a more effective solution than air conduction devices.1 The Baha System offers a trio of powerful sound processors to meet individual needs. With access to Made for iPhone, Android compatibility and True Wireless™ accessories, patients are always connected to the sounds of life. The Baha System is unique in that it allows patients to demonstrate the benefits of the system prior to implantation. For pediatric patients under the age of five, non-surgical options are available until they are ready for implantation. The brand new SoundArc, and the similar Softband, are great options for children. The SoundArc and Softband give children the opportunity for early and consistent access to sound in order to promote speech and language development.

Candidacy and Evaluation

Candidacy evaluation for an implantable bone conduction system includes audiological testing as well as a personal trial with the Baha System. The patient’s air-bone gap can be a guide to the benefits that can be expected from choosing a Baha System. There may also be medical indications, which show that a bone conduction implant system will be the best solution. If possible, compare the results of the functional gain measurements in the sound field booth, with and without the sound processor.

MHL CHL in peds

Implantation can be achieved once the surgeon determines sufficient bone thickness and quality, which can vary among individuals. In the United States and Canada, labeling states that a bone-anchored implant can be placed at 5 years of age and older.

For infants or children who are not ready for implantation, Cochlear recommends the Baha Softband or the new Baha SoundArc. Both are nonsurgical options for children under age 5. This can be a good indication of the possible benefits the Baha System may provide for a child. It can also help make the decision easier to implant the child, once benefits have been observed.

It is critical to give pediatric patients early access to sound in order to promote speech and language development. Children who receive hearing rehabilitation before the age of six months perform significantly better in language tests at the age of 3 to 4 years than children who are treated later2. Studies conclude that delay in intervention may lead to permanent language deficit.2

Treatment and Fitting

When treating a pediatric Baha patient with MHL/CHL, it is important to choose the correct sound processor to ensure adequate power/gain. The benefit of a more powerful sound processor is most obvious at higher frequencies because these are weakened to a greater extent than low frequencies when passing through the skin.3 When using the SoundArc, Softband or Baha Attract System skin attenuation should be kept in mind.

Research suggests that pediatric patients with binaural MHL/CHL should be fitted with bilateral sound processors using the Baha Softband or SoundArc. 2, 4 Since early access to sound is crucial, it is best that a pediatric patient is fitted with Baha Sound Processors before the age of six months.2, 4

In conclusion, the Baha System offers a powerful portfolio of solutions for adults and pediatrics with MHL and CHL. The Baha portfolio includes different surgical and non-surgical options and a trio of powerful sound processors to meet individual needs.

If you are interested in bringing the Baha system into your clinical practice, please reach out to your Cochlear Field Team today. Don’t know who your Field Team members are?  Call: 1-800-523-5798 or 303-790-9010 and we can connect you today!

If you are already a Baha provider, please right-click and save the infographic below to use during counseling.

MHL CHL Baha

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* Play audiometry can be carried out with warble tones, speech or animal sounds.
References:
  1. Snik AF, Mylannus EA, Proops DW, et al. Consensus statements on the BAHA system where do we stand at present? The Annals of Otology, Rhinology & Laryngology 2005; 195:1-12.
  2. Yoshinaga-Itano C. Early Intervention after universal neo-natal hearing screening: impact on outcomes. Dev Disabil Res Rev. 2003;9(4):252-66.
  3. Håkansson B, Tjellström A., Rosenhall U. Hearing thresholds with direct bone conduction versus conventional bone conduction. Scand Audiol. 1984; 13(1):3-13.
  4. Dun CA, de Wolf MJ, Mylanus EA, Snik AF, Hol MK, Cremers CW. Bilateral bone-anchored hearing aid application in children: The Nijmegen experience from 1996 to 2008. Otol Neurotol. 2010; 31(4):615-23.
  5. Mylanus EAM, van der Pouw KCTM, Snik AFM, Cremers CWRJ. Intraindividual Comparison of the Bone-Anchored Hearing Aid and Air-Conduction Hearing Aids. Arch Otolaryngol Head Neck Surg. 1998; 124(3):271–276. doi:10.1001/archotol.124.3.268
Author

Jamie Schwartz

Jamie is the Associate Marketing Manager in the Product and Professional Marketing Department at Cochlear Americas. Jamie is responsible for ProNews blog content as well as professional social posts and calendars. If you are interested in being a guest author for the ProNews blog please contact Jamie by email at jschwartz@cochlear.com.

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New Codes for AOI Fitting Services: Five Steps to Prepare for 2024

November 28, 2023

Effective January 1, 2024, audiologists who program auditory osseointegrated implant (AOI) devices will have two newly established Current Procedural Terminology (CPT©, American Medical Association) codes to report their services. 

CPT Codes 92622 and 92623 have established service descriptors and assigned Relative Value Units (RVUs), allowing professionals a predictable pathway for reimbursement of services rendered. 

CPT 92622: Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes

CPT 92623: Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes

Five recommendations to prepare:

  1. Familiarize yourself with the new codes and descriptors so you know when and how to use them. 
    1. Update the clinic’s superbill to include these new codes. If you are unfamiliar with superbills or would like to review templates, ASHA, AAA, and ADA offer resources and templates which you may find useful.
    1. Educate and coordinate with billing staff, billing software vendors, or Electronic Data Interchange (EDI) clearinghouse to ensure they are also aware of and ready for claims with the new service codes.
  2. Establish charges for the new codes and services which align with the clinic’s pricing protocol and policy and procedures.
    • While healthcare professionals have discretion to charge appropriate amounts for their services, charges should remain consistent, regardless of type of payment or patient’s insurance status.
  3. Review/Update your clinic’s billing procedures.
    • Prior to the appointment:
      • Confirm patient information, insurance information, and coverage details. 
      • Verify coverage of services by health plans and potential prior authorization requirements.
      • Confirm/inform patients of any financial responsibility and consider collecting copayments at the appointment.
    • After the appointment:
      • Complete notes and documentation of services rendered to support medical necessity of care.
      • Include a clear description reflecting the time associated with the services.
      • Capture relevant information on superbill or in billing software to prepare claims for filing.
  4. Complete a claims review to ensure payers process claims appropriately. 
    • Track the initial claims with these new CPT codes across insurance payers using the new AOI fitting codes.
    • Compare allowed amounts for covered services to fee schedules/negotiated contracted rates.
    • Review the remittance advice to understand any denial reasons, and file appeals when pathways are available.
  5. Follow up with any payers if new CPT codes have not been uploaded in their annual update.
    • Share a written request for adoption of codes within the audiology code set.  Provide a summary of the CPT code(s), descriptor(s), and service(s) included.
    • Appeal any denials for non-covered services based on the CPT code reported. 

For any questions or additional resources, please reach out to your Cochlear Market Access & Payer Strategy (MAPS) Manager. You can locate your regional manager’s contact information here: MAPS Manager Contact Information

All specific references to CPT codes and descriptions are ©2023 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. CPT and CPT material are copyrights of American Medical Association (AMA): CPT Copyright 2020 American Medical Association, all rights reserved. CPT is a registered trademark of the American Medical Association.  

The information provided in this document is provided as guidelines only to address the unique nature of implantable hearing solutions technology. This information does not constitute reimbursement or legal advice. Cochlear Americas makes no representation or warranty regarding this information or its completeness, accuracy, fitness for any purpose, timeliness, or that following these guidelines will result in any form of coverage or reimbursement from any insurance company or federal health care program payer. The information presented herein is subject to change at any time. This information cannot and does not contemplate all situations that a health care professional may encounter. To be sure that you have the most current and applicable information available for your unique circumstances, please consult your own experts and seek your own legal advice regarding your reimbursement and coding needs and the proper implementation of these guidelines. All products should be used according to their labelling. In all cases, services billed must be medically necessary, actually performed, and appropriately documented in the medical record.  

Cochlear receives FDA clearance to lower the age for the Osia® System to 5 years old

April 19, 2024
  • In the United States, the Osia System is now cleared for children ages 5 and older
  • The Osia System, which launched commercially in 2020, is indicated for people with conductive hearing loss, mixed hearing loss and single-sided sensorineural deafness (SSD)
  • The Osia System has been shown to provide clinically significant improvements high frequency hearing for children.2,3,4

Lone Tree, Colo. (April 19, 2024) – Cochlear Limited (ASX: COH), the global leader in implantable hearing solutions, obtained U.S. Food and Drug Administration (FDA) clearance to lower the age of the Cochlear™  Osia System from 12 years-old to 5 years-old for children with conductive hearing loss, mixed hearing loss and single-sided sensorineural deafness (SSD).

The Osia System is a new category of bone conduction hearing solutions that uses digital piezoelectric stimulation to bypass damaged areas of the natural hearing system to send sound vibrations directly to the inner ear (cochlea). It is the first and only active bone conduction system that allows patients to undergo MRI scans at both 1.5 T and 3.0 T without the need for surgery.1

Now children as young as 5 will be able to have full access to the Osia System’s unique technology that is optimized to deliver high power and clarity, especially in high-frequency sounds, which are important for hearing what others are saying.

“I love my Osia. It’s given me the confidence to succeed in school. I can hear everything my teacher and my friends say,” Adrian R., 8-year-old Osia System recipient said.

Adrian was diagnosed with hearing loss at age 4 and started with the Baha® Sound Processor with a Baha Softband before transitioning to the Osia System at age 6.

“It has been amazing to see the transformation in Adrian. She has been doing so well in school and is able to keep up with her friends both in school and out. She is even learning the piano now and I never thought I would be able to say that. It has truly been life changing,” Dea R., parent to 8-year-old Adrian said.

The Osia System has been shown to provide clinically significant improvements in high frequency hearing for children.2,3,4

“I choose the Osia System for my pediatric patients because it really made the difference in terms of the sound clarity. It is absolutely incredible,” Dr. Daniela Carvalho, Pediatric Otolaryngologist at Rady Children’s Hospital said.

“All of my patients with the Osia System have come back to my office saying it’s the first time they’ve heard the birds chirping or other high-frequency sounds.”

Cochlear’s product portfolio is inspired by meaningful innovation and a core belief that technology is only as useful as the benefit it provides.

“The Osia System is transformative technology, and we’re pleased that it’s now accessible for children as young as 5. This aligns with our commitment to empower people across all stages of life to stay connected and thrive,” Lisa Aubert, President, Cochlear North America said.

About Cochlear Limited (ASX: COH)
People have always been Cochlear’s inspiration, ever since Professor Graeme Clark set out to create the first multi-channel cochlear implant after seeing his father struggle with hearing loss.  Since 1981, Cochlear has provided more than 750,000 devices in more than 180 countries, helping people of all ages around the world to hear.  As the global leader in implantable hearing solutions, Cochlear connects people with life’s opportunities, and welcomes them to the world’s largest hearing implant community.

Cochlear has a global workforce of around 4,800 people, with a passion for progress, who strive to meet the needs of people living with hearing loss. The company continually innovates to anticipate future needs, investing more than AUD$2.7 billion to date in research and development to push the boundaries of technology and help more people hear.

For further information please contact:
Christy LaPlante – PR Manager Cochlear Americas
E: pr-cochlearamericas@cochlear.com

  1. Ellsperman SE, Nairn EM, Stucken EZ. Review of Bone Conduction Hearing Devices. Audiol Res. 2021;11(2):207-219.
  2.  ClinicalTrials.Gov ID NCT 0500931
  3.  You, P., A. Choi, J. Drob, S. M. Hunsaker, Y. C. Liu, and R. Silva. 2022. ‘Early Outcomes of a New Active Transcutaneous Bone Conduction Implant in Pediatric Patients’, Otol Neurotol, 43: 212-18.
  4. Florentine, M. M., J. Virbalas, and D. K. Chan. 2022. ‘Early surgical and audiologic outcomes of active, transcutaneous, osseointegrated bone-conduction hearing device (Osia 2® system) placement’, International Journal of Pediatric Otorhinolaryngology, 156.

In the United States and Canada, the Osia System is indicated for ages 5 and older.

© Cochlear Limited 2024. All rights reserved.



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©Cochlear Limited 2024. All rights reserved. ACE, Advance Off-Stylet, AOS, Ardium, AutoNRT, Autosensitivity, Baha, Baha SoftWear, BCDrive, Beam, Bring Back the Beat, Button, Carina, Cochlear, 科利耳, コクレア, 코클리어, Cochlear SoftWear, Contour, コントゥア, Contour Advance, Custom Sound, DermaLock, Freedom, Hear now. And always, Hugfit, Human Design, Hybrid, Invisible Hearing, Kanso, LowPro, MET, MP3000, myCochlear, mySmartSound, NRT, Nucleus, Osia, Outcome Focused Fitting, Off-Stylet, Piezo Power, Profile, Slimline, SmartSound, Softip, SoundArc, True Wireless, the elliptical logo, Vistafix, Whisper, WindShield and Xidium are either trademarks or registered trademarks of the Cochlear group of companies. The names of actual companies and products mentioned herein may be the trademarks of their respective owners.

 

This material is intended for health professionals. If you are a consumer, please seek advice from your health professional about treatments for hearing loss. Outcomes may vary, and your health professional will advise you about the factors which could affect your outcome. Always read the instructions for use. Not all products are available in all countries. Please contact your local Cochlear representative for product information.

 

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