For outpatient, the leveling is based on: MDM or time.
MDM consists of problem, data and risk.
Problem: if chronic and stable, low (level 3). If chronic and not stable, then moderate (level 4); possibly but unlikely high (level 5). It all depends how severe the SNHL is and any exacerbation, progression, or side effects of treatment.
Data: assuming none, so minimal/none (level 2)
Risk: This is where you need to really level each visit based on the documentation. If SNHL can carry a risk, but the clinician is not documenting and discussing these risks and/or treatment options with the patient, then you cannot count them. The severity of SNHL can also play a factor here. You may have 2 patients with same SNHL diagnosis, but patient A is 88 y/o wheelchair bound with very mild SNHL in one ear, and patient B is a 42 y/o professional musician with significant SNHL in both ears. The management and risks for each of these patients with the same diagnosis could be different.
If you had to do your own research to determine the risks, then they are not currently being documented sufficiently to count them. As coders, we take the words on the page and translate into ICD10, CPT, HCPCs. It sounds like in your examples, the words are not on the page. It may be helpful to provide guidance to your providers regarding documentation. You should never tell your providers how to treat, but rather advise IF something is being discussed or decided to ensure that is reflected in the record.