CurrentCareFirstPolicy N/A

Rhinomanometry and Acoustic Rhinometry Coverage Criteria

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This policy addresses the use of rhinomanometry and acoustic rhinometry to evaluate nasal airway patency and related clinical applications (e.g., allergy testing, obstructive sleep apnea evaluation, preoperative assessment) for CareFirst members.

Policy Summary

PayerCareFirst

PolicyRhinomanometry and Acoustic Rhinometry Coverage Criteria

Policy CodePolicy N/A

Change TypeNo material change

Effective DateN/A

Last ReviewAug 1, 2023

Next Review DateN/A

Key ActionVerify member benefits and prior authorization requirements with CareFirst before performing testing.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

experimentalcoverage stance

510(k) devicesFDA clearance

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CurrentCareFirstPolicy N/A

Rhinomanometry and Acoustic Rhinometry Coverage Criteria

Customize your policy alerts

Sign up for all CareFirst policy alerts

Know when CareFirst releases new policies or updates existing guidance.

Monitor payer policy activity

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Policy Summary

PayerCareFirst

PolicyRhinomanometry and Acoustic Rhinometry Coverage Criteria

Policy CodePolicy N/A

Change TypeNo material change

Effective DateN/A

Last ReviewAug 1, 2023

Next Review DateN/A

Key ActionVerify member benefits and prior authorization requirements with CareFirst before performing testing.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

experimentalcoverage stance

510(k) devicesFDA clearance

varies by contractcoverage caveat

Coverage Determination

inv-01: Not covered — Experimental/Investigational

Not covered — Experimental/Investigational. Covered when ALL of the following are met:

Experimental/Investigational Determination: Rhinomanometry and acoustic rhinometry are considered experimental/investigational for all indications because they do not meet TEC/BCBSA criteria 2-5 (insufficient evidence of effect on health outcomes, lack of demonstrated net health benefit, uncertain benefit versus alternatives, and limited use outside investigational settings).

Devices may have FDA 510(k) clearance but lack evidence of improved net health outcome and comparable benefit to alternatives.

Rhinomanometry and acoustic rhinometry are not covered. These procedures are considered experimental/investigational for all indications because they do not meet TEC criteria #2–#5 as stated in the policy.

Coverage for rhinomanometry and acoustic rhinometry may vary by contract and line of business. Verify the member’s specific benefits and any applicable contractual limitations before applying the terms of this policy.

The impact of rhinomanometry and acoustic rhinometry on net health outcomes has not been determined.

Device Examples and Coding

FDA-cleared device examplesmixed

Rhinostream Rhinomanometer	FDA 510(k) clearance received October 4, 2002
AI Acoustic Rhinometer	FDA 510(k) clearance received September 30, 1998
SGS ECCOVISION Pharyngometer	FDA 510(k) clearance received November 9, 2017
SGS ECCOVISION Rhinometer	FDA 510(k) clearance received November 9, 2017
SGS ECCOVISION Rhino/Pharyngometer	FDA 510(k) clearance received November 9, 2017

Provider Actions and Billing Guidance

Prior Authorization

Prior authorization

Prior authorization is not addressed in this policy. CareFirst has provided no provider guidelines or specific authorization instructions for rhinomanometry or acoustic rhinometry in this policy document.

Prior Authorization

Verify prior authorization

Coverage and prior authorization requirements vary by contract and line of business. Verify member benefits and any prior authorization requirements with CareFirst before performing testing.

Coverage and prior authorization requirements differ by contract and line of business.
Contact CareFirst to confirm benefits and any required authorizations prior to service.

Note

Provider guidelines

Background

Rhinomanometry measures nasal airway pressure and airflow during respiration to calculate nasal airway resistance, providing a functional assessment of nasal obstruction. Acoustic rhinometry uses reflected sound waves to measure cross-sectional area and volume of the nasal passage, producing an anatomic assessment of nasal cavity geometry.

These techniques have been proposed for clinical uses such as evaluation of nasal obstruction, allergy testing, preoperative assessment for nasal surgery, and assessment in sleep‑disordered breathing, but available literature and reviews (examples cited in the policy) have not established that they improve net health outcomes compared with established alternatives such as nasal endoscopy or diagnostic imaging.

Definitions

Rhinomanometry — definition

TermRhinomanometry

DefinitionMeasurement of air pressure and the rate of airflow in the nasal airway during respiration to calculate nasal airway resistance.

Clinical useFunctional assessment of nasal airway patency and response to decongestants or interventions.

Acoustic rhinometry — definition

TermAcoustic rhinometry

DefinitionTechnique using a reflected sound signal to measure cross-sectional area and volume of the nasal passage to assess nasal cavity geometry.

Clinical use

Policy Summary

PayerCareFirst

PolicyRhinomanometry and Acoustic Rhinometry Coverage Criteria

Policy CodePolicy N/A

Change TypeNo material change

Effective DateN/A

Last ReviewAug 1, 2023

Next Review DateN/A

Key ActionVerify member benefits and prior authorization requirements with CareFirst before performing testing.

SourceLink

On This Page

There are no additional provider guidelines in this policy. Providers should follow any applicable CareFirst provider instructions communicated separately.

Note

Benefit contract note

Check the member's contract for benefits. Specific contract provisions, restrictions, and exclusions take precedence over the clinical criteria in this Medical Policy Reference Manual.

Member contract provisions supersede policy criteria.
Always check the member's contract for benefits before applying this policy.

Documentation Required

Supporting references

References were reviewed during development of this policy and are listed in the policy bibliography. CareFirst does not endorse the referenced sources and is not responsible for their content.

Denial Risk

Denial risk / Coverage verification required

Rhinomanometry and acoustic rhinometry are considered experimental/investigational for all indications; claims will be denied on that basis unless contract language indicates otherwise. Coverage will vary by contract and line of business — verify before applying this policy.

Claims for rhinomanometry and acoustic rhinometry will generally be denied as experimental/investigational.
Verify coverage prior to service; exceptions only if member contract provides contrary language.

Anatomic description of nasal passage and evaluation of nasal obstruction; used for pre/postoperative assessment.

Acoustic rhinometry — supporting details

Evidence baseMultiple references evaluate acoustic rhinometry in nasal obstruction, decongestant testing, and postoperative assessment (see Porter et al., Roithmann et al., and others).

Method detailsAcoustic rhinometry provides an objective measure of cross-sectional area and volume of the nasal airway using sound reflections; reproducibility and sensitivity have been studied in the literature.

Clinical applications in literatureStudied in nasal provocation testing, evaluation of decongestant effect, and correlation with patient sensation of nasal patency.

Rhinomanometry — supporting details

Functional measureRhinomanometry quantifies pressure/flow relationships during the respiratory cycle to calculate nasal airway resistance.

Comparative notesLiterature compares rhinomanometry with acoustic rhinometry and other measures (e.g., nasal peak flow); studies assess sensitivity and reproducibility.

Proposed usesUsed in evaluation of nasal obstruction, allergy testing, obstructive sleep apnea assessment, and preoperative nasal surgery evaluation.