Low-level laser therapy may be considered medically necessary for prevention of oral mucositis in patients undergoing cancer treatment associated with increased risk of oral mucositis, including chemotherapy and/or radiotherapy, and/or hematopoietic cell transplantation (see Policy Guidelines).
Low-level laser therapy is considered investigational for all other indications including but not limited to:
Carpal tunnel syndrome
Neck pain
Subacromial impingement
Adhesive capsulitis
Temporomandibular joint pain
Low back pain
Osteoarthritic knee pain
Heel pain (ie, Achilles tendinopathy, plantar fasciitis)
Rheumatoid arthritis
Bell palsy
Fibromyalgia
Wound healing
Lymphedema.
