Joy you do bring up a great point.
When we use it off label to treat patients other than breast cancer, I just
explain that it is approved for use in BCRL and not in the case of their cancer
but that they do not have contraindications for use-there just hasn’t been much
research in these other cancers and thus why it has not been FDA approved. But
that we would be using it in the same manner as I would with a breast cancer
patient. And I leave it up to them if they are still willing to proceed.
Dr. Abby Hegerfeld, PT, DPT
Board Certified Specialist in Oncologic Physical Therapy
Certified Lymphedema Therapist (CLT)
Credentialed Clinical Instructor (CCI)
Parkview Therapy Services: Outpatient Physical Therapist
Residency Preceptor: Parkview Oncology Residency
11143 Parkview Plaza Dr.
Suite 100
Fort Wayne, IN 46845
Phone: 260-266-4080
Fax: 260-266-4089
Clinic Hours:
Monday – Thursday : 9-5:30
Friday : 9-4:30
From: aptaoncology-bounce@xxxxxxxxxxxxx <aptaoncology-bounce@xxxxxxxxxxxxx> On
Behalf Of Yoder, Sara M *HS
Sent: Thursday, June 09, 2022 8:16 AM
To: 'aptaoncology@xxxxxxxxxxxxx' <aptaoncology@xxxxxxxxxxxxx>
Subject: [aptaoncology] Re: Low level laser
WARNING: This email came from an external source outside of Parkview Health.
DO NOT CLICK on links or attachments from unknown senders or unexpected emails.
You bring up a great point Joy, thank you! How do folks who use LLLT off label
approach this with patients?
Sara
From:
aptaoncology-bounce@xxxxxxxxxxxxx<mailto:aptaoncology-bounce@xxxxxxxxxxxxx>
<aptaoncology-bounce@xxxxxxxxxxxxx<mailto:aptaoncology-bounce@xxxxxxxxxxxxx>>
On Behalf Of Cohn, Joy
Sent: Wednesday, June 8, 2022 7:32 PM
To: aptaoncology@xxxxxxxxxxxxx<mailto:aptaoncology@xxxxxxxxxxxxx>
Subject: [aptaoncology] Re: Low level laser
Two excellent articles discussing mechanism of action, effects, protocols etc
for laser in Head and Neck CA:
Zecha JAEM et al. Low level laser therapy/photobiomodulation in the management
of side effects of chemoradiation in Head and Neck Cancer. Parts 1 and 2
Support Care CA 24:2781-2805. 2016.
Though the specific wavelength of the Rian Corp laser (908 nm) is not discussed
specifically in these articles we also utilize the Rian Corp laser.
It must be remembered that LLLT was approved by the FDA for use solely in BCRL.
Other uses are still off label!
From:
aptaoncology-bounce@xxxxxxxxxxxxx<mailto:aptaoncology-bounce@xxxxxxxxxxxxx>
<aptaoncology-bounce@xxxxxxxxxxxxx<mailto:aptaoncology-bounce@xxxxxxxxxxxxx>>
On Behalf Of Yoder, Sara M *HS
Sent: Wednesday, June 8, 2022 1:59 PM
To: 'aptaoncology@xxxxxxxxxxxxx'
<aptaoncology@xxxxxxxxxxxxx<mailto:aptaoncology@xxxxxxxxxxxxx>>
Subject: [External] [aptaoncology] Re: Low level laser
The riancorp laser is the one we are getting as well. As a follow up email for
anyone else considering getting a low level laser: I reached out to riancorp
to ask about billing and reimbursement (a lot of times the manufacturers of
devices collect this information as well). This is what the representative
from riancorp responded with:
The billing code information that we have are as follows:
97039: Attended Modality, Unspecified
This is a code that is also being used to bill for attended modalities.
Reimbursement is good because it is understood to take more time than an
unattended code. The problem with the code is that, being unspecified, it is
occasionally rejected by some insurance carriers or hand audited. Make sure you
have a one-page description of the treatment if a carrier wants more
information. When the claim form goes out it will usually say something like:
97039: Attended Laser Therapy
97140: Manual Therapy Techniques
This code is for a manual therapy technique meaning that the practitioner must
have one-on-one contact with the patient and perform manual therapy. The
weakness of the code is that an unlisted procedure is more likely to be closely
inspected by insurance carrier. In this case the practitioner must be using
light therapy as an adjunct to some type of manual therapy.
Billing might look like:
97139: Manual Therapy + Laser Therapy
It seems the most common code used is the manual therapy indicating the laser
is being used while providing some form of manual therapy.
Best,
Sara
From:
aptaoncology-bounce@xxxxxxxxxxxxx<mailto:aptaoncology-bounce@xxxxxxxxxxxxx>
<aptaoncology-bounce@xxxxxxxxxxxxx<mailto:aptaoncology-bounce@xxxxxxxxxxxxx>>
On Behalf Of Abby Hegerfeld
Sent: Wednesday, June 8, 2022 1:39 PM
To: aptaoncology@xxxxxxxxxxxxx<mailto:aptaoncology@xxxxxxxxxxxxx>
Subject: [aptaoncology] Re: Low level laser
Hi Nancy,
Yes, we use the riancorp low level laser. I’ve attached the website with all of
the information for it below:
Low Level Laser Therapy (LLLT) | LTU-904 | Postmastectomy
(riancorp.com)<https://www.riancorp.com/the-product/the-product-page>
While all/most of the current research is on breast cancer, we use the laser
with our head and neck cancer patients, gynecological and melanoma (or anyone
with LE swelling or abdominal, and genital lymphedema). We have had amazing
success with the abdominal lymphedema patients that have a lot of induration
and it has helped to soften up the skin greatly.
Please let me know if you have any other questions on it!
Dr. Abby Hegerfeld, PT, DPT
Board Certified Specialist in Oncologic Physical Therapy
Certified Lymphedema Therapist (CLT)
Credentialed Clinical Instructor (CCI)
Parkview Therapy Services: Outpatient Physical Therapist
Residency Preceptor: Parkview Oncology Residency
11143 Parkview Plaza Dr.
Suite 100
Fort Wayne, IN 46845
Phone: 260-266-4080
Fax: 260-266-4089
Clinic Hours:
Monday – Thursday : 9-5:30
Friday : 9-4:30
From:
aptaoncology-bounce@xxxxxxxxxxxxx<mailto:aptaoncology-bounce@xxxxxxxxxxxxx>
<aptaoncology-bounce@xxxxxxxxxxxxx<mailto:aptaoncology-bounce@xxxxxxxxxxxxx>>
On Behalf Of Gage, Nancy
Sent: Tuesday, June 07, 2022 9:12 AM
To: 'aptaoncology@xxxxxxxxxxxxx'
<aptaoncology@xxxxxxxxxxxxx<mailto:aptaoncology@xxxxxxxxxxxxx>>
Subject: [aptaoncology] Re: Low level laser
WARNING: This email came from an external source outside of Parkview Health.
DO NOT CLICK on links or attachments from unknown senders or unexpected emails.
Hi Abby-
Do you have any information on the particular machine you use? I am thinking of
purchasing one so I am looking fro recommendations
Thanks
Nancy Gage PT DPT
Director, Rehabilitation Services
(508) 210-5955
[cid:image001.png@01D87BF9.C2A36170]
From:
aptaoncology-bounce@xxxxxxxxxxxxx<mailto:aptaoncology-bounce@xxxxxxxxxxxxx>
<aptaoncology-bounce@xxxxxxxxxxxxx<mailto:aptaoncology-bounce@xxxxxxxxxxxxx>>
On Behalf Of Abby Hegerfeld
Sent: Sunday, June 5, 2022 8:17 AM
To: aptaoncology@xxxxxxxxxxxxx<mailto:aptaoncology@xxxxxxxxxxxxx>
Subject: [aptaoncology] Re: Low level laser
We also have the low level laser that we use for lymphedema, scar tissue, and
axillary web syndrome and get great results.
Our therapy compliance told us that there is no code for it; so it is either a
no charge or you can bill under manual as long as its used with other manual
interventions (which is what we always do).
Dr. Abby Hegerfeld, PT, DPT
Board Certified Specialist in Oncologic Physical Therapy
Certified Lymphedema Therapist (CLT)
Credentialed Clinical Instructor (CCI)
Parkview Therapy Services: Outpatient Physical Therapist
Residency Preceptor: Parkview Oncology Residency
11143 Parkview Plaza Dr.
Suite 100
Fort Wayne, IN 46845
Phone: 260-266-4080
Fax: 260-266-4089
Clinic Hours:
Monday – Thursday : 9-5:30
Friday : 9-4:30
From:
aptaoncology-bounce@xxxxxxxxxxxxx<mailto:aptaoncology-bounce@xxxxxxxxxxxxx>
<aptaoncology-bounce@xxxxxxxxxxxxx<mailto:aptaoncology-bounce@xxxxxxxxxxxxx>>
On Behalf Of Anna Buckmaster
Sent: Friday, June 03, 2022 6:18 PM
To: aptaoncology@xxxxxxxxxxxxx<mailto:aptaoncology@xxxxxxxxxxxxx>
Subject: [aptaoncology] Re: Low level laser
WARNING: This email came from an external source outside of Parkview Health.
DO NOT CLICK on links or attachments from unknown senders or unexpected emails.
We have a laser we’ve been using for about a month. We either use it as “no
charge” or most of the time combine with manual therapy. We have one hand
controlling the laser while other hand is completing MFR or MLD. So far,
getting some great results adding it to treatment!
Anna Buckmaster PT, DPT, CLT
Bozeman Health
Sent from my iPhone
On May 26, 2022, at 7:39 PM, Yvonne Harrison
<ymptaz@xxxxxxxxx<mailto:ymptaz@xxxxxxxxx>> wrote:
Hi...I recently did this very same SBAR...I'm out of office until next week but
can send then...With regard to coding we use the code for fluidotherapy with a
note that it was low level laser.
On Thu, May 26, 2022, 9:41 AM Yoder, Sara M *HS
<SMY6G@xxxxxxxxxxxxxxxxxxxxxxxx<mailto:SMY6G@xxxxxxxxxxxxxxxxxxxxxxxx>> wrote:
Good afternoon,
I am working on an SBAR to get a low level laser for use in our clinic for scar
tissue/wound healing, fibrosis, axillary webbing, etc. For anyone who is using
one, what code(s) are you using to bill and do you know how well it is
reimbursed? Any suggestions to help with an SBAR to justify purchase of the
laser are appreciated as well!
Best,
Sara Yoder, PT, DPT, CLT
UVA health
Emily Couric Clinical Cancer Center
Smy6g@xxxxxxxxxxxx<mailto:Smy6g@xxxxxxxxxxxx>