Medical policy: Rhinomanometry and Acoustic/Optical Rhinometry

Policy number: MP 2.088

Effective date: 9/1/2026

Policy

Rhinomanometry, acoustic rhinometry, and optical rhinometry are considered investigational. There is insufficient evidence to support a general conclusion concerning the health outcomes or benefits associated with these procedures.

Cross-References:

• MP 1.128 Surgical Treatment of Sleep Apnea and Snoring
• MP 2.045 Diagnosis of Obstructive Sleep Apnea

Product variations

This policy is only applicable to certain programs and products administered by Capital Blue Cross and subject to benefit variations. Please see additional information below.

FEP PPO - Refer to FEP Medical Policy Manual. The FEP Medical Policy manual can be found at:

FEP Medical Policy Manual.

Description/Background

Rhinomanometry, acoustic rhinometry, and optical rhinometry are techniques to objectively measure nasal patency. Several clinical applications are proposed including allergy testing, evaluation of obstructive sleep apnea, and patient assessment prior to nasal surgery.

Nasal patency is a complex clinical issue that can involve mucosal, structural and psychological factors. The perception of nasal obstruction is subjective and does not always correlate with clinical examination of the nasal cavity, making it difficult to determine which therapy might be most likely to restore satisfactory nasal breathing. Therefore, procedures that objectively measure nasal patency have been sought. Discussion of 3 techniques that could potentially be useful in measuring nasal patency follows.

Rhinomanometry is a test of nasal function that measures air pressure and the rate of airflow in the nasal airway during respiration. These findings are used to calculate nasal airway resistance. Rhinomanometry is intended to be an objective quantification of nasal airway patency.

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 uses 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.

Acoustic Rhinometer

The Eccovision® Acoustic Rhinometer (Sleep Group Solutions) also uses acoustic reflection technology and measures nasal patency and maps out the topography of the nasal airway identifying the location and severity of airway obstruction. The test is completed with the patient awake and seated during the exam which takes 30 seconds to complete.

Rationale

Summary

Overall, the scientific evidence does not permit conclusions about the effect of rhinomanometry, acoustic rhinometry or optical rhinometry on net health outcome. To date, there is inadequate evidence from published studies evaluating the clinical utility of these tests. That is, additional well-designed studies are needed to prospectively compare patient outcomes with and without the use of one or more of these tests to determine the utility and effectiveness for clinical conditions. Therefore, the technologies are considered investigational.

Definitions

Acoustic Reflection technology is based on the analysis of sound waves that are launched from a loudspeaker and travel along a wave tube into the subject’s airways where they are reflected. Measurement of differences in the reflected wave signals enables a graphic representation of the variations in pharyngeal cross-sectional area at several anatomic levels.

Acoustic Rhinometry is a non-invasive technique using acoustic reflection to study nasal physiology. It may be used to evaluate the nasal cavity to aid in the identification of fixed lesions such as septal deviations or alterations in cross-sectional area induced by allergens or drugs.

Disclaimer

Capital Blue Cross’ medical policies are used to determine coverage for specific medical technologies, procedures, equipment, and services. These medical policies do not constitute medical advice and are subject to change as permitted by law or applicable clinical evidence from independent treatment guidelines. Treating providers are solely responsible for medical advice and treatment of members. These policies are not a guarantee of coverage or payment. Payment of claims is subject to a determination regarding the member’s benefit program and eligibility on the date of service, and a determination that the services are medically necessary and appropriate. Final processing of a claim is based upon the terms of contract that applies to the member’s benefit program, including benefit limitations and exclusions. If a provider or a member has a question concerning this medical policy, please contact Capital Blue Cross’ Provider Services or Member Services.

Coding information

Note: This list of codes may not be all-inclusive, and codes are subject to change at any time. The identification of a code in this section does not denote coverage as coverage is determined by the terms of member benefit information. In addition, not all covered services are eligible for separate reimbursement.

Investigational; therefore, not covered:

References

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