Ear Lavage

Documentation Requirement Reminder

1.Impacted cerumen present on exam and noted as a diagnosis. If done for other than impaction please note reasoning.

2.Documentation by provider that nurse performed lavage.

3.After cerumen is removed-Documentation by provider of examination of the ear/ears. (This service is being performed under the supervision of that provider.)

4.Enter Ear Lavage order twice if bilateral lavage completed.

CPT defines impacted cerumen as the following-

•Visual considerations: Cerumen impairs exam of clinically significant portions of the external auditory canal, tympanic membrane, or middle ear condition.

•Qualitative considerations: Extremely hard, dry, irritative cerumen causing symptoms such as pain, itching, hearing loss, etc.

•Inflammatory considerations: Associated with foul odor, infection, or dermatitis.

•Quantitative considerations: Obstructive

**REPORT THE APPROPRIATE LEVEL OF SERVICE

IF CERUMEN IS NOT IMPACTED**