Cerumen
cerumen removal
types of cerumen removal
coding
coding
100

five precautions to cerumen management

read license laws

determine if there are restrictions in work place

follow CDC's precautions

obtain informed consent

develop plan for medical emergencies

100

name three methods to cerumen removal

mechanical removal with instruments, suction, and irrigation with water

100

when irrigation is indicated

more complete occlusions with hardened/dry wax

100

importance of coding (5) 

to document procedures that were carried out (CPT) 

to reflect diagnosis and findings (ICD 10)

to code hearing devices with HCPCS codes

show continuity of care, what has been done, and next steps

required for reimbursement 

100

HCPCS

based on CPT codes to promote common language

200

4 risks for cerumen removal

scraping canal walls

perforate TM

make chronic ME disorder worse

damage ossicular chain

200

mechanical removal with instruments

most common

for partially occluded canal, when wax is not adhered to skin

requires using sterilized instruments to remove cerumen

200

when to mechanically remove wax

partially occluded canal and wax is not adhered to skin 

200

CPT defined

current procedural terminology codes

- document procedures to describe medical, surgical, diagnostic, and rehab procedures 

200

HCPCS facts

different levels of codes

audiologists mainly use level II for durable medical equipment (DME) (aka hearing devices) 

300

name 7 contraindications to cerumen removal

ear pain

drainage

ear surgery

dizziness

diabetes (irrigation) 

AIDS

anything else that puts pt at risk (large ECV, CHL, MHL, ME dysfunction) 

300

irrigation (water)

water gently introduced in canal

don't direct stream at ear drum

point toward canal wall w/ least amount of wax

often drape pt with towel and have them hold basin

use irrigation with more complete occlusions and when wax is hardened

300

two methods that are not recommended for cerumen removal

cotton swabs and ear candling 

300

CPT info

belong to American Medical Association

5 digits

updated often 

300

92557

basic comprehensive audiometry (AC, BC, SRT, WRS)

400

cerumenolytic

agents that soften cerumen with active ingredients (carbamide peroxide and gylcerin) recommended prior to cerumen removal 
400

four types of instruments to remove wax

curettes, wire loops, alligator forceps, specula tip for otoscopy

400

92553

pure tone audiometry, air and bone

400

ICD 10 defined

diagnoses and descriptions of what was found as a result of CPT codes

400

92551

screening, pure tone, air only

500

2 examples of cerumenolytics

audiologists choice, debrox, murine ear wax removal system 

500

summarize potential threat to hearing posed by removing cerumen via suction

suction equipment may produce loud sounds next to ear and pose a threat to create NIHL, tinnitus, or both 

500

92555

speech audiometry threshold

500

ICD 10 facts

owned by WHO 

must be justifiable and supported by documentation 

allows health data to be tracked, standard tool for clinical purposes

audiologists have been using these since 80s 

required for reimbursement

letters and numbers

most start with H for no reason 

500

92552

pure tone audiometry, air only

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