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07.00.14h, Low-Level Laser Therapy
Effective date
Not stated in the notice
Identified
Jun 19, 2026
Summary
Independence Blue Cross reissued Policy 07.00.14h on 10/29/2025 to communicate its continuing position on Low-Level Laser Therapy (LLLT). The policy covers LLLT only for prevention of oral mucositis in cancer patients undergoing chemotherapy, radiotherapy, or stem cell transplant; all other uses remain experimental/investigational and non-covered. CPT code 97037 was added to the experimental/investigational category effective 01/02/2024, and billing teams must not misrepresent LLLT services using incorrect codes like 97026.
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What to do
Action · 7 steps
01REQUIREMENTS:
- Immediately: Audit billing records to identify any claims billed with CPT 97026 (infrared therapy) or other misrepresented codes for LLLT services.
02Flag for post-payment review and audit per policy requirements.
03- Billing team must update claim scrubbing rules to ensure CPT 1011T (medically necessary for oral mucositis prevention) is only approved when accompanied by qualifying cancer treatment diagnosis codes: Z51.0, Z51.11, Z92.21, Z92.3, or Z94.84.
04- Billing team must deny or redirect all claims for CPT 97037, 0552T, and S8948 when billed for any indication other than oral mucositis prevention in cancer patients; these codes are experimental/investigational and non-covered per policy.
05- Update provider education materials and billing guidance to clarify that LLLT for carpal tunnel syndrome, neck pain, back pain, osteoarthritis, rotator cuff injuries, and all other listed conditions (26+ conditions enumerated) are NOT covered.
06- Billing team must reject claims billed with CPT 97037 or 0552T without prior verification of qualifying cancer treatment diagnosis; include policy reference in denial letters.
07- Consequences: Claims billed with incorrect coding or for non-covered conditions will be denied and subject to post-payment audit and recovery procedures.
Codes mentioned
97037S8948
Original notice
07.00.14h, Low-Level Laser Therapy
medpolicy.ibx.com · Always check the source before changing claims.
Related changes
See all Independence Blue Cross changes →MA07.036d, Low-Level Laser TherapyMediumNo effective date · Medical PolicyMA07.036e, Low-Level Laser TherapyMediumEffective Jan 1, 2026 · Medical Policy07.00.14i, Low-Level Laser TherapyMediumEffective Jan 1, 2026 · Medical PolicyMA10.003j, Outpatient Physical Medicine and Rehabilitation Services- Physical Therapy (PT) and Occupational Therapy (OT)HighEffective Jan 15, 2024 · Medical PolicyBrowse every Independence Blue Cross change in the policy list