Insurance Hurdles for Laser Authorization in Pediatric Patients

Laser procedures are safe and effective for various medical conditions in the pediatric population. Laser therapies are viewed as elective or cosmetic rather than medically necessary leading to their denial. Laser therapy can be deemed experimental or investigational, due to a lack of sufficient high-quality evidence showing that the treatment is safe, effective, and necessary for a medical condition. There is also lack of specific Current Procedural Terminology codes leading to the use of unlisted procedure codes that cause an increase in denials or initiation of prior authorizations. Overall, insurance coverage of laser procedures in pediatric patients is highly inconsistent.