BlueCross BlueShield of Tennessee Medical Policy Manual

Phonophoresis for Medical Indications

DESCRIPTION

Phonophoresis is the use of ultrasound to enhance the delivery of topically applied drugs. Phonophoresis has been used in an effort to enhance the absorption of topically applied analgesics and anti-inflammatory agents through the therapeutic application of ultrasound.

POLICY

Phonophoresis for medical indications is considered investigational.

See also: Iontophoresis for Medical Indications

ADDITIONAL INFORMATION

The evidence in the literature is insufficient to permit conclusions regarding the health outcomes and effects of phonophoresis for medical indications.

Phonophoresis for medical indications does not meet the following technology evaluation criteria:

• The scientific evidence must permit conclusions concerning the effect of the technology on health outcomes.

• The technology must improve the net health outcome.

• The technology must be as beneficial as any established alternatives.

• The improvement must be attainable outside the investigational settings.

SOURCES

Altchek, D. W., & Levinson, M. (2000). The painful shoulder in the throwing athlete. Orthopedic Clinics of North America, 31 (2), 241-245.

Bare, A. C., McAnaw, M. B. B., Pritchard, A. D., Struebing, J. G., Smutok, M, A., Christie, D. S., et al. (1996). Phonophoretic delivery of 10% hydrocortisone through the epidermis of humans as determined by serum cortisol concentrations. Physical Therapy, 76 (7), 746-749. Abstract retrieved July 27, 2000 from PubMed database.

Byl, N. N. (1995). The use of ultrasound as an enhancer for transcutaneous drug delivery: Phonophoresis. Physical Therapy, 75 (6), 539-553. Abstract retrieved July 27, 2000 from PubMed database.

Gogstetter, S., & Goldsmith, L. A. (1999). Treatment of cutaneous sarcoidosis using phonophoresis. Journal of the American Academy of Dermatology, 40 (5), 767-769.

Klaiman, M. D., Shrader, J. A., Danoff, J. V., Hicks, J. E., Pesce, W. J., & Ferland, J. (1998). Phonophoresis versus ultrasound in the treatment of common musculoskeletal conditions. Medicine and Science in Sports and Exercise, 30 (9), 1349-55. Abstract retrieved July 27, 2000 from PubMed database.

Mantone, J., Burkhead, W. Z., & Noonan, J. (2000). Nonoperative treatment of rotator cuff tears. Orthopedic Clinics of North America, 31 (2), 295-311.

Rosenstein, E. D. (1999). Topical agents in the treatment of rheumatic disorders. Rheumatic Diseases Clinics of North America, 25 (4) 899-918.

Van der Windt DAWM, Van der Heijden GJMG, Van den Berg SGM, Ter Riet G, De Winter AF, Bouter LM. Ultrasound therapy for acute ankle sprains (Cochrane Review). In: The Cochrane Library, Issue 4, 2003. Chichester, UK: John Wiley & Sons, Ltd.

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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