Low-Level Laser and High-Power Laser Therapy - (CPG030)

Cigna covers low‑level laser therapy (photobiomodulation; CPT 97037, 0552T, HCPCS S8948) only to prevent oral mucositis in patients undergoing cancer treatments that increase mucositis risk (chemotherapy, radiotherapy, hematopoietic cell transplant); all other LLLT uses are not medically necessary and high‑power/Class IV laser therapy (CPT 97039) is experimental/investigational for all indications. Claims must use the policy’s listed ICD‑10 cancer/mucositis diagnosis codes and appropriate procedure codes and include documentation of medical necessity (diagnosis/reason, duration/parameters, treatment area, pre/post observations and clinical response) or they will be denied.

"Low-level laser therapy is considered medically necessary for prevention of oral mucositis in patients undergoing cancer treatment associated with increased risk of oral mucositis, including chemot..."