GL173-non-contact-ultrasound-97610



In January 2018, these codes were moved to Guideline Note 173.CPT 97610 Low frequency, non-contact, non-thermal ultrasoundLast reviewed at VbBS in October, 2013 and approved with new CPT codes. Minutes indicate that the staff recommendation was accepted without significant discussion.The following was presented in the meeting materials for the October, 2013 VbBS meeting:Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment (CPT 97610)Definition: Noncontact, low-frequency ultrasound is a technology intended to remove necrotic tissue from chronic wounds (debridement) and to stimulate closure of non-healing wounds.LiteratureCullum 2011, Cochrane review of ultrasound therapy for chronic leg ulcersN=8 trials were included; all had unclear, or high, risks of bias6 trials evaluated high frequency ultrasoundSignificantly more patients healed with US than without it at 7 - 8 weeks (pooled RR 1.4, 95% CI 1.0 to 1.96), but later assessments at 12 weeks showed the increased risk of healing with US was no longer statistically significant (pooled RR 1.47, 95% CI 0.99 to 2.20). 2 RCTs evaluated low frequency US Both trials reported no evidence of a difference in the proportion of ulcers healed with US compared with no USConclusions: The trials evaluating US for venous leg ulcers are small, poor-quality and heterogeneous. There is no reliable evidence that US hastens healing of venous ulcers. There is a small amount of weak evidence of increased healing with US, but this requires confirmation in larger, high-quality RCTs. There is no evidence of a benefit associated with low frequency US.Voight 2011, meta-analysis of ultrasound for chronic wound healingN=8 RCTs Results demonstrated that early healing (at ≤5 months) in patients with venous stasis and diabetic foot ulcers was favorably influenced by both high- and low-intensity ultrasound delivered at a low frequency—either via contact or noncontact techniques.However, the quality of the data may be suspect, especially for low-frequency low-intensity noncontact ultrasound because of significant biases. Other policiesBCBS 2013Use of low-frequency, non-contact, non-thermal, ultrasound therapy is considered investigational and not medically necessary for all applications.Recommendation: Excluded List ................
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