CPT® Code 89190

1. Indications

The nasal smear for eosinophils is indicated for the evaluation of various allergic conditions. The primary indications for performing this procedure include:

• Allergic Rhinitis - The procedure is commonly performed to support the diagnosis of allergic rhinitis, a condition characterized by an allergic response that leads to symptoms such as sneezing, nasal congestion, and runny nose.
• Other Allergic Conditions - It may also be indicated in the assessment of other allergic disorders where eosinophil levels may be relevant.

2. Procedure

The procedure for obtaining a nasal smear for eosinophils involves several key steps, which are detailed as follows:

• Step 1: Sample Collection - The first step involves collecting nasal secretions. This can be achieved by inserting a sterile swab into each nostril, specifically targeting the area near the septum and nasal floor. The swab should be held in place for a duration of 15 to 30 seconds, or until a cough reflex is triggered, which indicates that an adequate sample has been obtained. Alternatively, the patient may be asked to blow their nose into a piece of waxed paper or cellophane to gather the nasal secretions.
• Step 2: Slide Preparation - After the nasal secretions are collected, a small portion of the sample is placed onto a clean glass slide. This step is crucial for preparing the sample for microscopic examination.
• Step 3: Staining - The sample on the slide is then stained using appropriate laboratory techniques. Staining is essential as it enhances the visibility of eosinophils under the microscope, allowing for accurate counting and assessment.
• Step 4: Microscopic Examination - The stained slide is examined under a light microscope by a trained laboratory technician. During this examination, the technician counts the number of eosinophils present in the sample, which is a critical component of the diagnostic process.
• Step 5: Reporting Results - Finally, the findings from the microscopic examination are documented and reported. The results will indicate the eosinophil count, which can provide valuable information for diagnosing allergic conditions.

3. Post-Procedure

Post-procedure care for a nasal smear for eosinophils is generally minimal, as the procedure is non-invasive and does not typically require any special recovery measures. Patients may resume their normal activities immediately following the test. However, it is important for healthcare providers to inform patients about potential mild discomfort during the sample collection process, such as nasal irritation or a brief cough reflex. The results of the nasal smear will be communicated to the patient in a timely manner, and any necessary follow-up or additional testing will be discussed based on the findings.