Authorized distributor of Phothera narrowband UVB phototherapy systems
Provider Brief — Home Narrowband UVB Phototherapy
Your patient is requesting a prescription for a home NB-UVB phototherapy device. This page summarizes what is required to complete the order and support reimbursement.
What is being requested
A home narrowband UVB (311–313 nm) phototherapy unit, prescribed for a dermatologic indication and billed under the patient’s durable medical equipment benefit. Devices are manufactured by Phothera and distributed by Cytokind.
Device and diagnosis codes
| Device (HCPCS) | Common indications (ICD-10) |
E0691 — Phothera 200, 2 sq ft (hand & foot) E0692 — Phothera 400, 4 ft panel E0693 — Phothera 600, 6 ft panel E0694 — Phothera 600-3D, 6 ft |
L40.9 — Psoriasis L20.9 — Atopic dermatitis L80 — Vitiligo L29.9 — Pruritus L74.51 — Hyperhidrosis C84.A3 — Cutaneous T-cell lymphoma F33 — Seasonal affective disorder |
What the order form requires from you
- Provider information, including NPI number.
- Device selection and diagnosis code.
- Statement of medical necessity, including affected body surface area and severity (a BSA calculator is built into the form).
- Previous treatments trialled, and the clinical rationale for home-based therapy.
- Prescriber signature on the certification statement.
Supporting documentation
Clinical notes, chart notes or medical records documenting medical necessity may be uploaded directly to the form, or faxed alongside the order to 419.636.7916. Incomplete documentation is the most common cause of payer denial.
To complete the order: open the secure form at form.jotform.com/261756968405066, or use the resume link your patient has sent you. The form may be completed and signed electronically — no in-person visit is required.
Reimbursement support
Claims, prior authorizations and appeals on denied cases are handled through Phothera’s patient assistance program, Phothera Cares. Patients facing out-of-pocket barriers may also apply to that program separately; it is not insurance and eligibility is determined by Phothera.
Questions
Cytokind can speak with your office directly regarding device selection, documentation requirements, or benefit verification.
Cytokind, Inc. · 18 Forest Ring Drive, Intervale, NH 03845
+1 603-264-7751 · www.cytokind.net