BlueCross BlueShield of Tennessee Medical Policy Manual

Light Emitting Diode (LED) Therapy

DESCRIPTION

Light emitting diode (LED) therapy utilizes a device (e.g., Anodyne Therapy System, Pain-X-2000, BioScan, Light Force Therapy) that delivers light to targeted tissue. This is done through multiple LEDs located on a flexible pad that is in contact with the skin. LED therapy may also be referred to as infrared energy therapy, infrared light therapy or infrared heating pad system.

LED therapy devices use one (monochromatic) or two wavelengths of infrared (invisible) light with or without red (visible) light. The light is measured in nanometers, with a higher nanometer number denoting a greater depth of tissue penetration. Treatment is administered several times a week over a period of weeks to months. LED therapy can be provided in an office or home setting.

LED therapy is being proposed for the treatment of diabetic peripheral neuropathy, lymphedema, non-healing wounds and pain. Treatment is based on the premise that LED therapy may cause an increase in nitric oxide concentrations that may lead to increased blood flow and promote vasodilatation.

POLICY

IMPORTANT REMINDERS

ADDITIONAL INFORMATION

Scientific evidence in peer review literature is lacking regarding the use, safety, improvement or effectiveness on health outcomes for light emitting diode therapy.

SOURCES  

BlueCross BlueShield Association. Medical Policy Reference Manual. (11:2011). Skin contact monochromatic infrared energy as a technique to treat cutaneous ulcers, diabetic neuropathy, and miscellaneous musculoskeletal conditions (1.01.22). Retrieved February 7, 2012 from BlueWeb. (12 articles and/or guidelines reviewed)

BMC Psychiatry. (2007, August). A controlled trial of the Litebook light-emitting diode (LED) light therapy device for treatment of Seasonal Affective Disorder (SAD). Retrieved April 7, 2009 from http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1971065&blobtype=pdf.

Health Technology Assessment Information Service. Target database. (2006, January). Monochromatic infrared irradiation for peripheral neuropathic pain. Retrieved February 22, 2006 from ECRI HTAIS.

U. S. Food and Drug Administration. (2005, August). Center for Devices and Radiological Health. Device listing database. Retrieved February 22, 2006 from http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/search/search.cfm?db=LST&ID=93425.

Winifred S. Hayes, Inc. Medical Technology Directory. (2008, April; last update search April 2011). Low level light therapy for peripheral neuropathy. Retrieved April 6, 2009 from www.Hayesinc.com/subscribers. (40 articles and/or guidelines reviewed)

Winifred S. Hayes, Inc. Medical Technology Directory. (2008, April; last update search April 2011). Low level light therapy for soft tissue pain. Retrieved February 7, 2012 from www.Hayesinc.com/subscribers. (62 articles and/or guidelines reviewed)

Winifred S. Hayes, Inc. Medical Technology Directory. (2008, March; last update search March 2011). Low level light therapy for joint pain. Retrieved February 7, 2012 from www.Hayesinc.com/subscribers. (33 articles and/or guidelines reviewed)

Winifred S. Hayes, Inc. Medical Technology Directory. (2008, May; last update search April 2011). Low level light therapy for temporomandibular joint pain. Retrieved April 6, 2009 from www.Hayesinc.com/subscribers. (30 articles and/or guidelines reviewed)

ORIGINAL EFFECTIVE DATE:  12/1/2003  

MOST RECENT REVIEW DATE:  3/8/2012

ID_BA

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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