HIGHMARK COMMERCIAL MEDICAL POLICY - PENNSYLVANIA

 
 

Medical Policy:
E-41-012
Topic:
Transtympanic Micropressure Applications as a Treatment of Meniere's Disease
Section:
Durable Medical Equipment
Effective Date:
September 11, 2017
Issued Date:
February 11, 2019
Last Revision Date:
February 2019
Annual Review:
February 2019
 
 

Transtympanic micropressure pulses (Meniett Device) are transmitted to the middle ear to cause displacement of the perilymphatic fluid thus relieving the symptoms of Meniere’s disease.

Policy Position

Transtympanic micropressure applications (e.g. Meniett device) as a treatment of Meniere’s disease are considered not medically necessary.

A4638  

E2120

 

 

 

 

 




H81.01

H81.02

H81.03

H81.09

 

 



Place of Service: Inpatient/Outpatient

Transtympanic micropressure applications as a treatment of Meniere's disease is typically an outpatient procedure which is only eligible for coverage as an inpatient procedure in special circumstances, including, but not limited to, the presence of a co-morbid condition that would require monitoring in a more controlled environment such as the inpatient setting.


The policy position applies to all commercial lines of business



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