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Photodynamic Therapy Informed Consent Form PDT Blue Light

Photodynamic Therapy Informed Consent Form PDT Blue Light 2025

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The document is a consent form for Photodynamic Therapy (PDT) using Levulan (Aminolevulinic acid 20%) to treat pre-cancerous skin lesions and improve various skin conditions. It outlines the treatment process, potential side effects, post-treatment care instructions, and the understanding that results may vary. The patient acknowledges their understanding of the information provided and consents to the treatment.

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Click ‘Get Form’ to open the Photodynamic Therapy Informed Consent Form PDT Blue Light in the editor.
Begin by carefully reading each section of the form. Initial each section to confirm your understanding. If you have questions, do not initial and seek further information.
Fill in your personal details, including your name and date, at the designated fields. This ensures that your consent is properly documented.
Review the potential side effects listed in the form. Acknowledge your understanding by initialing next to each point regarding discomfort, burning, and other reactions.
Sign the form where indicated to confirm your consent for treatment. Ensure that both you and a witness sign and date the document.

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Is photodynamic therapy red or blue light?

While red light is the standard of photodynamic therapy care globally, it is considered off-label in the United States. Due to blue lights poor , it is not a very good treatment for skin cancer, those at high risk for occult skin cancers, or acne.

Is blue light the same as PDT?

PhotoDynamic Therapy (PDT) also known as Blue Light is a treatment for actinic keratoses or pre-cancerous skin lesions. Blue light therapy is becoming increasingly popular in Southwest Florida. It is an alternative to liquid nitrogen, Efudex, Carac, and Aldara.

What is the CPT code for blue light photodynamic therapy?

- Common Procedural Terminology (CPT) codes: o Blue light application code 96574 / 96573 / 96567 (only one applies per patient, per day, based on actual treatment protocol utilized). In our office, code 96574 is the most typically applicable CPT code.

What is the wavelength of blue light in PDT?

Although only red light around 635 nm and blue light around 400 nm are used as light sources for PDT, the efficiency of PDT might be improved by using multiple wavelengths, including those that correspond to the other absorption peaks of PpIX.

Is red light therapy the same as photodynamic therapy?

In fact, red light therapy is already widely medically accepted in its use in photodynamic therapy. In this therapy, low-power red laser light is used to activate a photosensitizer drug. The interaction creates a chemical reaction that destroys cells.

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Is photodynamic therapy the same as blue light therapy?

Blue Light Therapy / photodynamic therapy is commonly used to treat acne, actinic keratosis (precancerous skin lesions), sun-damaged skin, and sometimes even fine lines and uneven pigmentation.

What color light is used in photodynamic therapy?

Photodynamic therapy (PDT) is a special treatment performed with solution that sensitizes your skin to light. The solution is called Levulan (5-aminolevulinic acid or ALA) and it is applied to your skin for 30-90 minutes. Afterwards, a blue light is shined over your skin for 17 minutes to activate the solution.

Photodynamic Therapy Informed Consent Form PDT Blue Light 2025

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Is photodynamic therapy red or blue light?

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Is red light therapy the same as photodynamic therapy?

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Is photodynamic therapy the same as blue light therapy?

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