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Acoustic rhinometry is a technique intended for assessment of 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.  Optical rhinometry utilizes an emitter and a detector placed at opposite sides of the nose and can detect relative changes in nasal congestion by the change in transmitted light.  This technique is based on the absorption of red/near-infrared light by hemoglobin and the endonasal swelling-associated increase in local blood volume.

The techniques are proposed for use in allergey testing, comparing decongestive action of antihistamines and corticosteroids, for evaluation of obstructive sleep apnea and for assessment of the patient prior to nasal surgery.

Ten models of rhinomanometers or acoustic rhinometers have received marketing clearance by the U.S. Food and Drug Administration (FDA) 510(k) mechanism between 1984 and 2002.  Optical rhinometry is a new technique that is being developed in Europe; at the time of the latest review, no devices had received clearance for marketing in the U.S.

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Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary.

The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language.

4/5/2001: Policy reviewed; Title changed, Description and Policy revised, Managed Care Requirements deleted, Sources updated

2/14/2002: Investigational definition added

5/2/2002: Type of Service and Place of Service deleted

6/7/2002: Code Reference section completed

9/20/2002: Policy reviewed

8/5/2005: Code References section reviewed, no changes

3/10/2006: Policy reviewed, no changes

3/28/2007: Policy reviewed and description updated, no changes to policy statement

6/24/2008: Policy reviewed and optical rhinometry references included

Blue Cross Blue Shield Association policy # 2.01.08

Non-Covered Codes

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