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Grenz rays have been used by dermatologists since the 1920's. At one time, it was an important treatment tool, but with all the recent medical advances it is rarely used today. It is used to calm down inflammation of the skin and will not cause damage as seen with prolonged use of cortisone creams. It is occasionally very helpful for conditions that fail to fully respond to other treatments. Grenz treatments are not a replacement for other treatments but are added to them to get a more complete result.
Grenz rays are a form of black light. Similar to ultraviolet light, x-rays, and gamma rays, these are all composed of photons, which are packets of electro-magnetic energy traveling at the speed of light. Grenz rays are produced at low kilovoltages giving them a very low penetration power. Half their energy is absorbed within the first half millimeter of tissue, which means that they do not penetrate beneath the skin.
Due to its very limited level of penetration, Grenz rays are classified as ultrasoft radiation. They do not carry the risks of other forms of radiation when proper radiation safety measures are followed. Grenz ray treatments should not be confused with the "superficial radiation therapy" or "superficial X-Ray" which were used for everything from acne to eczema back 30 to 40 years ago, and are still used in the treatment of malignant skin cancers today.
The usual course of Grenz treatment consists of weekly or bi-weekly treatments over three or four sessions. Treatments giving over 200 Rads will cause a mild sunburn reaction at the site. A persistent dark, tan may linger for several months afterwards. Hair loss does not occur. Subsequent treatments may be repeated two or three times yearly, if needed.
Uses of Grenz therapy include treatment of the last lingering spots of mycosis fungoides, atopic dermatitis, contact dermatitis, psoriasis, Haily-Haily disease, lichen simplex chronicus, hand eczema, and anogenital itching including pruritus ani.
Grenz ray therapy is considered investigational.
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language.
Investigative is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized as a generally accepted standard of good medical practice for the treatment of the condition being treated and; therefore, is not considered medically necessary. For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting.
POLICY HISTORY11/2003: Approved by Medical Policy Advisory Committee (MPAC)
1/21/2004: Code Reference section completed.
10/17/2006: Policy reviewed, no changes.
07/30/2015: Code Reference section updated for ICD-10.
05/26/2016: Policy number added.
CODE REFERENCEThis may not be a comprehensive list of procedure codes applicable to this policy.