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PEDIATRIC DESCRIPTION OF APPOINTMENTS INITIAL CONSULT TIME: ~ 90 minutes Includes meeting with a team audiologist to discuss hearing loss, cochlear implant candidacy, the process for implantation, benefits of implantation and to review currently available cochlear implant devices and technology. Audiologic, medical and educational records will also be reviewed. Please come prepared to this appointment with a list of questions and concerns based on information we have provided or that you have learned elsewhere. The case history and insurance forms should also be returned at this time. Hearing aids must be worn to this appointment. Note: If appropriate hearing aids are not worn, earmolds will be taken at this appointment ($55.00/each payable at time of service) to begin a mandatory hearing aid trial. HEARING AID FITTING (if appropriate) TIME: ~ 60-90 minutes The FDA requires that a cochlear implant candidate must be appropriately fit with amplification for both ears prior to implantation to demonstrate benefit from hearing aids. Loaner hearing aids may be provided by The Listening Center at $25.00 each for a period of 2 months. AUDITORY BRAINSTEM RESPONSE (ABR) and/or OTOACOUSTIC EMISSIONS TESTING (OAE) These objective measures of hearing sensitivity may require sedation. This appointment takes approximately 120 minutes. Note: Testing may not be necessary if complete test results are available from a previous assessment. AUDIOLOGICAL ASSESSMENT TIME: ~60-180 minutes Includes a complete hearing assessment with and without hearing aids. Speech perception tests will be performed to determine speech understanding with optimally fit hearing aids. Depending on the age of the child, it may take several appointments to complete testing. Note: Preimplant training may be recommended at this time. CT SCAN TIME: Varies A special x-ray of the inner ear will be obtained to evaluate the anatomy of the cochlea. The CT scan can be done locally or at Johns Hopkins pending insurance requirements. The patient/parent is responsible for bringing these films to the otologic consult (appointment with the doctor). OTOLOGIC CONSULT TIME: Varies An otologist will take a detailed medical history, review the CT scan, determine if medical contraindications exist, and determine if a general physical is needed before surgery. This appointment will also include a discussion of available cochlear implant devices, surgery and recovery. If appropriate, other evaluations may be recommended. (Continued on Back) REHABILITATION CONSULT TIME: 90 minutes A case history is taken; auditory skills evaluated and educational placement is reviewed. The need for preimplant training is discussed and determined at this time. Hearing aids must be worn to this appointment. SPEECH-LANGUAGE EVALUATION TIME: 90-120 minutes The child’s current communication abilities will be evaluated through informal and/or formal assessment methods and future communication goals will be discussed. Hearing aids must be worn to this appointment. OPHTHALMOLOGIC EXAM (vision) TIME: Varies A basic pediatric eye exam to determine the vision status of the patient since many hearing impaired individuals rely on vision to help them communicate. It may also help rule out any syndromic involvement. Contact your pediatrician regarding where to have this appointment completed. It is the responsibility of the parent to provide the results to the implant team. PSYCHOLOGICAL/SOCIAL CONSULT TIME: 90 minutes Psychological and social development, as well as expectations and coping strategies of the implant recipient and their family members, are discussed and evaluated. Bring all insurance information to this appointment. It is your responsibility to obtain any referrals or authorizations required by your insurance carrier for this service. Give CPT (procedure) code 96150 and diagnosis code 389.18 (sensorineural hearing loss) when calling. Please do not assume that this service will be covered. You need to contact your insurance company. Co-pay, if applicable, is due at time of service. If you come to the appointment without a required referral or authorization the appointment will be rescheduled, or you will be required to pay in full at time of service. Please call Jermey Raines 410-502-6755 if you have any questions. DEVICE DISCUSSION TIME: 30-60 minutes Includes a review of devices, surgery, and post-operative care. At the completion, the patient/parents select a device. HEARING AIDS MUST BE WORN TO ALL APPOINTMENTS!