Cerumen Impaction: Best Practices and Documentation

00:00 Here are some summary comments.

00:02 First of all, don't forget you'll need to document in your documentation.

00:07 You want to put your initial assessment the presence of hearing loss, whether it was unilateral or bilateral, the procedure, the outcome, and the post-procedure change to hearing.

00:18 Every patient is different, but most people don't need this done more than every year or two. Usually, taking regular hot showers is sufficient to keep normal wax production draining from the ear normally.

00:32 I will give you a reminder.

00:34 Don't let patients hang their head over for the shower to spray in their ear, as that could possibly cause ear perforation, and we don't want this to occur.

00:46 Also, in your unhoused population who don't have access to regular hot water, they may develop hardened earwax and this can cause impaction issues and compromise their hearing. So sometimes the earwax may be hard enough that you're not able to soften it when they're in your office. So you can prescribe two different things for them to do.

01:10 You can either give them debrox drops to use, which they would use twice a day for seven days in return for you. Or you could have them do the glazed capsule or a couple of drops of olive oil would work as well. In your older adults and young children, they may also struggle with earwax buildup due to the anatomical and physiological changes.

01:34 You may see this in people who work in factories where they pick up debris, or people who work outside, like in lawn services, and may require this to have the ear irrigation more often.

01:47 No matter the population, most ear specialists agree that Q-tips are not recommended to remove earwax, and so they come to you for help.

01:57 Flushing to remove earwax is safer, and we all want our patients to be safe.

02:05 For this procedure, there are relevant ICD-10, CPT codes for billing, which have to do with whether there was greater than ten minutes of provider time.

02:15 If there was partial or full impaction, the need for modifier codes that will include which ear, the right or left, or whether it was bilateral .

02:25 Cerumen impaction sounds gross to some people, but removal is very helpful.

02:30 Thank you for watching.