DESCRIPTION
Rhinomanometry measures air pressure and the rate of airflow in the nasal airway during respiration. These measurements are then used to calculate nasal airway resistance. Rhinomanometry is intended to be an objective quantification of nasal airway patency.
Acoustic rhinometry is a technique used to assess the geometry of the nasal cavity and nasopharynx and for evaluating nasal obstruction. The technique is based on an analysis of sound waves reflected from the nasal cavities.
Both techniques are proposed for use in comparing decongestive action of antihistamines and corticosteroids. These techniques are also proposed for assessment of an individual prior to or following nasal surgery. Testing is generally done in an outpatient setting.
POLICY
Rhinomanometry and/or acoustic rhinometry for the diagnosis of all nasal conditions is considered investigational.
IMPORTANT REMINDER
We develop Medical Policies to provide guidance to Members and Providers. This Medical Policy relates only to the services or supplies described in it. The existence of a Medical Policy is not an authorization, certification, explanation of benefits or a contract for the service (or supply) that is referenced in the Medical Policy. For a determination of the benefits that a Member is entitled to receive under his or her health plan, the Member's health plan must be reviewed. If there is a conflict between the Medical Policy and a health plan, the express terms of the health plan will govern.
ADDITIONAL INFORMATION
Published scientific evidence in the form of well-designed studies in peer review journals is lacking regarding the utilization of rhinomanometry and acoustic rhinometry in clinical management. There is no evidence that these techniques are more clinically relevant or accurate compared to self-assessment and self-reporting.
SOURCES
BlueCross BlueShield Association. Medical Policy Reference Manual. (3:2010). Rhinomanometry and acoustic/optical rhinometry (2.01.08). Retrieved November 9, 2011 from BlueWeb. (15 articles and/or guidelines reviewed)
Chandra, R. K., Patadia, M. O., & Raviv, J. (2009). Diagnosis of nasal airway obstruction. Otolaryngology Clinic of North America, 42 (2), 207-225.
National Guideline Clearinghouse. (2008, August). The diagnosis and management of rhinitis. An updated practice parameter. Retrieved October 13, 2009 from http://www.guidelines.gov.
Tan, B. K., & Lane, A. P. (2009). Endoscopic sinus surgery in the management of nasal obstruction. Otolaryngology Clinic of North America, 42 (2), 227-240.
Tombu, S., Daele, J., & Lefebvre, P. (2010). Rhinomanometry and acoustic rhinometry in rhinoplasty. B-ENT, 6 (Suppl. 15), 3-11.
U. S. Food and Drug Administration. (2010, April). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K092611. Retrieved November 10, 2011 from http://www.accessdata.fda.gov/cdrh_docs/pdf9/K092611.pdf.
U. S. Food and Drug Administration. (2002, October). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K022311. Retrieved November 9, 2011 from http://www.accessdata.fda.gov/cdrh_docs/pdf2/k022311.pdf.
Wustenberg, E. G., Zahnert, T., Huttenbrink, K. B., & Hummel, T. (2007). Comparison of optical rhinometry and active anterior rhinomanometry using nasal provocation testing. Archives of Otolaryngology - Head & Neck Surgery, 133 (4), 344-349.
ORIGINAL EFFECTIVE DATE: 8/1985
MOST RECENT REVIEW DATE: 12/8/2011
ID_BA
Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.
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