Rhinomanometry, Acoustic Rhinometry, Optical Rhinometry and Acoustic Pharyngometry

This policy covers rhinomanometry, acoustic rhinometry, optical rhinometry, and acoustic pharyngometry for objective assessment of nasal and pharyngeal airway patency—used for conditions such as nasal obstruction, allergy-related airflow changes, preoperative nasal surgery evaluation, OSA-related nasal contribution, nasal polyps/adenoids, septal deviation, and assessment for mandibular appliance candidacy. Major limitations/requirements: the policy considers these modalities experimental/investigational and not covered (acoustic pharyngometry noted as not covered for all indications), only certain devices have FDA 510(k) clearance, member benefit plans and state regulations govern coverage, and the evidence is limited and inconclusive.

"Objective measurement of nasal patency"

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