CommercialCoverageMedium impact
Rhinometry and Rhinomanometry (CPB 0700, reviewed 2025-11-24)
Aetna·ENT (Ear, Nose & Throat)·Medical Policy
Effective date
Nov 24, 2025
We identified it
Aug 16, 2026
Summary
Aetna has classified rhinomanometry, acoustic rhinometry, and optical rhinometry as experimental, investigational, or unproven procedures. CPT code 92512 (Nasal function studies) is not covered for the specified ICD-10 indications including acute sinusitis, allergic rhinitis, chronic sinusitis, deviated septum, and nasal turbinate hypertrophy. Billing teams must implement denial protocols for these procedures when billed with these diagnoses.
Action Required
Effective immediately (November 24, 2025): Billing team must update billing software to deny or require manual review for CPT 92512 (Nasal function studies/rhinomanometry) when billed with ICD-10 codes J01.00-J01.91, J30.1-J30.9, J32.0-J32.9, J34.2, or J34.3 for Aetna commercial plans. Add a hard stop or alert in the billing system to flag these combinations before claim submission. Communicate this change to ENT providers and front desk staff to prevent claim denials. Do not bill these procedures with these diagnoses to Aetna; claims will be denied as experimental/investigational services.