Patient presents with complaints of decreased hearing in the left ear.  Onset is reported as gradual over the past six months.  Associated symptoms include tinnitus in the left ear, described as a constant ringing, and occasional difficulty understanding speech in noisy environments.  No reported ear pain, discharge, vertigo, or history of head trauma.  Patient denies significant noise exposure.  Family history is negative for hearing loss.  Physical examination reveals normal appearing external auditory canals and tympanic membranes bilaterally.  Weber test lateralizes to the right ear.  Rinne test is positive bilaterally.  Pure tone audiometry confirms sensorineural hearing loss in the left ear, with thresholds elevated across all frequencies.  Diagnosis of sensorineural hearing loss, left ear, is made.  Differential diagnosis includes presbycusis, noise-induced hearing loss, and acoustic neuroma.  Treatment plan includes referral to audiology for further evaluation and consideration of hearing aids for left ear hearing amplification.  Patient education provided regarding hearing loss causes, treatment options, and assistive listening devices.  Follow-up scheduled in three months to assess response to treatment and monitor hearing status.  ICD-10 code H91.22, Sensorineural hearing loss, left ear, assigned.  CPT codes for audiometry and evaluation will be determined based on the specific procedures performed.