Pulsed Dye Laser Treatment

PDL is covered for actinic keratoses (only after inadequate response to topical imiquimod or 5‑FU or to cryosurgery), genital warts (only after failed home podophyllotoxin or imiquimod), granuloma faciale, infantile hemangiomas, and keloids/hypertrophic scars secondary to injury/surgery that cause significant pain requiring chronic analgesics or significant functional impairment; it is considered experimental/investigational for all other indications and not covered for cosmetic uses (e.g., dyschromia, facial redness/rosacea, telangiectasias, spider angiomas, stretch marks, hair removal). Key requirements: documentation of prior-treatment failure for actinic keratoses and genital warts, and documentation of pain/functional impairment for keloid coverage.

"Basal cell carcinoma (PDL and combined PDL+Nd:YAG have been studied; PDL showed variable results; combined PDL+Nd:YAG showed partial/histologic clearance in some small series)."