Low Level Laser Therapy (LLLT)
DESCRIPTION
Low level laser therapy (LLLT) is also known as cold laser therapy. LLLT refers to the use of red-beam or near-infrared lasers. Low level lasers usually have a wavelength between 600 and 1,000 nm and Watts from 5-500 milliWatts. These lasers produce no sensation and do not burn when applied to the skin.
LLLT is being promoted as a way to treat a variety of clinical conditions. The exact mechanism of the effect of LLLT on these clinical conditions is not known.
POLICY
Low level laser therapy for the treatment of conditions / diseases, including, but not limited to, the following: carpal tunnel syndrome, musculoskeletal disorders, connective tissue disorders, degenerative disorders, arthritis, tuberculosis, tinnitus, pain, Raynaud’s syndrome, spider veins, telangiectasias, or as an adjunct to other treatments is considered investigational.
IMPORTANT REMINDER
We develop Medical Policies to provide guidance to Members and Providers. This Medical Policy relates only to the services or supplies described in it. The existence of a Medical Policy is not an authorization, certification, explanation of benefits or a contract for the service (or supply) that is referenced in the Medical Policy. For a determination of the benefits that a Member is entitled to receive under his or her health plan, the Member’s health plan must be reviewed. If there is a conflict between the Medical Policy and a health plan, the express terms of the health plan will govern.
ADDITIONAL INFORMATION
Well-designed studies published in peer-reviewed journals that fully address the performance of LLLT are lacking. There are no available standardized protocols for the use of LLLT. Thus, there is insufficient evidence to permit conclusions regarding the use of LLLT therapy instead of established alternatives or whether LLLT therapy improves net health outcomes.
SOURCES
BlueCross BlueShield Association. Medical Policy Reference Manual. (12:2009). Low-level laser therapy (2.01.56). Retrieved February 11, 2011 from BlueWeb. (26 articles and/or guidelines reviewed)
ECRI Institute. Health Technology Information Service. Hotline Response. (2010, April). Low-level laser therapy for carpal tunnel syndrome. Retrieved February 22, 2011 from ECRI Institute. (10 articles and/or guidelines reviewed)
ECRI Institute. Health Technology Information Service. Hotline Response. (2010, April). Low-level laser therapy for joint disorders. Retrieved February 22, 2011 from ECRI Institute. (58 articles and/or guidelines reviewed)
ECRI Institute. Health Technology Information Service. Hotline Response. (2010, April). Low-level laser therapy for muscle pain from fibromyalgia and myofascial pain syndromes. Retrieved February 22, 2011 from ECRI Institute. (20 articles and/or guidelines reviewed)
Technology Evaluation Center. (2010, November). Low-level laser therapy for carpal tunnel syndrome and chronic neck pain. (Vol. 25, No. 4). Chicago: BlueCross BlueShield Association. (34 articles and/or guidelines reviewed)
U. S. Food and Drug Administration. (2010, April). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K10016. Retrieved February 22, 2011 from http://www.accessdata.fda.gov/cdrh_docs/pdf10/K100116.pdf.
Winifred S. Hayes, Inc. Medical Technology Directory (2008, April). Low level light therapy for peripheral neuropathy. Retrieved February 22, 2011 from www.Hayesinc.com/subscribers. (40 articles and/or guidelines reviewed)
Winifred S. Hayes, Inc. Medical Technology Directory (2008, April). Low level light therapy for soft tissue pain. Retrieved February 22, 2011 from www.Hayesinc.com/subscribers. (62 articles and/or guidelines reviewed)
Winifred S. Hayes, Inc. Medical Technology Directory (2008, March). Low level light therapy for joint pain. Retrieved February 22, 2011 from www.Hayesinc.com/subscribers. (33 articles and/or guidelines reviewed)
Winifred S. Hayes, Inc. Medical Technology Directory (2008, May). Low level light therapy for temporomandibular join pain. Retrieved February 22, 2011 from www.Hayesinc.com/subscribers. (30 articles and/or guidelines reviewed)
ORIGINAL EFFECTIVE DATE: 10/1/2003
MOST RECENT REVIEW DATE: 4/14/2011
ID_BT
Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.
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