​​​​​Selective photothermolysis using pulsed-dye lasers

April 20, 2022

Effective for dates of service on or after July 11, 2022, Independence will update the policy position for selective photothermolysis using pulsed-dye lasers (PDL) for certain conditions as experimental/investigational.

  • psoriasis (e.g., plaque psoriasis and nail psoriasis)
  • molluscum contagiosum
  • basal cell carcinoma
  • cutaneous lupus erythematosus
  • cutaneous sarcoidosis (e.g., lupus pernio)

The position will be experimental/investigational because safety and/or effectiveness of PDL for these indications cannot be established by review of the available published peer-reviewed literature.

The policy update will also identify the following cosmetic conditions:*
  • striae distensae (stretch marks)
  • cherry angiomas
  • spider angiomas
  • telangiectasias (facial and leg when not associated with rosacea and meets medically necessary criteria)
  • wrinkles

For detailed information, please refer to the following policies, which were posted as Notifications on April 11, 2022, and will go into effect July 11, 2022:

*This is not a comprehensive list. However, they are common indications where usage of selective photothermolysis using PDLs results in cosmetic applications.