Patient presents with hearing loss, difficulty hearing, or hearing impairment.  Audiologic evaluation reveals reduced hearing acuity, impacting speech recognition and communication.  The degree of hearing loss may be characterized as mild, moderate, severe, or profound.  The type of hearing loss may be conductive, sensorineural, or mixed, based on audiometry findings including pure-tone thresholds, speech audiometry, and tympanometry.  Onset of hearing impairment may be gradual or sudden, unilateral or bilateral.  Patient reports difficulty understanding conversations, especially in noisy environments, needing others to repeat themselves, or turning up the volume on electronic devices.  Tinnitus, ringing in the ears, may be present.  Differential diagnosis includes impacted cerumen, otitis media, Meniere's disease, and acoustic neuroma.  Assessment includes otoscopic examination, audiological testing, and review of medical history including noise exposure, ototoxic medications, and family history of hearing loss.  Diagnosis of hard of hearing confirmed.  Treatment plan may include hearing aids, assistive listening devices, communication strategies, or referral to an otolaryngologist or audiologist for further evaluation and management.  Patient education provided regarding hearing loss prevention, communication techniques, and available support resources.  Follow-up scheduled to monitor hearing status and adjust treatment plan as needed.  ICD-10 code H91.9, hearing loss, unspecified, is documented for billing and coding purposes.