Thermography

This policy covers thermography as a diagnostic imaging procedure used to assist in evaluation of conditions such as breast cancer, complex regional pain syndrome (reflex sympathetic dystrophy), Raynaud phenomenon and digital artery vasospasm, peripheral nerve injury, deep vein thrombosis, burns, impaired spermatogenesis/infertility, headaches and lower back pain, rheumatoid arthritis treatment response, and localization of undescended testicles for surgical planning. However, thermography is considered experimental, investigational and/or unproven for any indication (including breast lesions) and is not covered; coverage is governed by the member’s benefit plan and state regulations, may be subject to local carrier discretion, and many thermography devices are 510(k)-cleared as adjuncts only rather than standalone diagnostic tools—refer to CMS NCD 220.11 for Medicare position.

"Assist in diagnosis of complex regional pain syndrome (reflex sympathetic dystrophy)."