ViziLite Plus as part of a comprehensive oral screening

Oral cancer is one of the most curable diseases when it's caught early. That's why the ViziLite Plus exam has been developed.  ViziLite Plus uses technology that has proven successful in identifying soft tissue abnormalities in other areas of the body.  A ViziLite Plus exam is particularly important if you are at increased risk for developing oral cancer.

For more information about ViziLite Plus and the ViziLite Plus examination, click here to view an informative ViziLite Plus video segment.  (A high speed internet connection and Windows Media Player 10 is recommended to view the video.  Download Windows Media Player 10)

The ViziLite Plus exam can help your dentist or hygienist identify abnormal tissue, that might develop into oral cancer.

An annual ViziLite Plus exam, in combination with a regular visual examination, provides a comprehensive oral screening procedure for patients at increased risk for oral cancer. The ViziLite Plus exam is painless and fast, and could help save your life.

ViziLite Plus is performed immediately following a regular visual examination

  • First, you will be instructed to rinse with a cleansing solution
  • Next, the overhead lighting will be dimmed.
  • Then, your dental professional will examine your mouth using ViziLite Plus, a specially designed light technology.

The Importance of Screening

How ViziLite Plus Works

As with most serious diseases, early detection is the key to successful outcomes. Unfortunately, the problem with oral cancer is that approximately 70% of the time it is not visible to the dental professional until it has reached an advanced stage. ViziLite Plus technology assists your dental professional in seeing abnormal tissue in the mouth, before it is plainly obvious.

As ViziLite Plus passes over oral tissue that has been treated with the rinse solution, normal healthy tissue will absorb the light and appear dark, abnormal tissue will appear white. The purpose of using ViziLite Plus is to identify tissue changes at their earliest stage; once abnormal tissue has been identified it is up to your dental professional to determine what the appropriate next steps are.

 
 
   

 Without ViziLite Plus

With ViziLite Plus 

Who should have a ViziLite Plus exam?

The American Cancer Society recommends that patients have a complete soft tissue examination (standard visual exam) at least once a year.

ViziLite Plus is used as part of an annual oral screening for patients at increased risk for oral cancer. Your dental professional may recommend a ViziLite Plus examination more frequently depending on your individual risk factors.

Oral Cancer Risk by Patient Profile:

Increased Risk:

    Patients age 18-39 with no lifestyle risk factors

High Risk:

    Patients age 40 and older with no risk factors OR patients age 18-39 with lifestyle risk factors      

Highest Risk:

    Patients age 40 and older with lifestyle risk factors or patients with a history of oral cancer

Risk Factors:

    Lifestyle risk factors for oral cancer include:
  • Tobacco use (any type, any age, within 10 years)
  • Alcohol consumption of at least 1 drink per day (3 ounces of hard liquor, 4 ounces of wine, or 12 ounces of beer)

Other risk factors:

  • Immune deficiencies such as HIV & AIDS
  • Human Papilloma Virus, particularly HPV 16/18

Am I at risk? - Take an online assessment

ViziLite Plus Insurance Coverage

Your medical and dental insurance benefits should not dictate the standard of care that you receive from a dental professional. This is especially important for screening procedures, such as the ViziLite Plus examination. Dentists that offer ViziLite Plus exams to their patients want their patients to receive the highest quality standard of care available.

Dental Insurance

The American Dental Association has established a dental insurance procedure code that applies to the ViziLite Plus exam. This code is the CDT-5 D0431 code.  Be sure to verify that your dentist has submitted a claim for this specific procedure and code.  Your dental plan may cover this procedure and both you and your dentist may not be aware of it. 

Medical Insurance

Your medical insurance company may also cover the ViziLite Plus exam.  There are medical insurance codes that have also been used to obtain insurance reimbursement for the ViziLite Plus exam.  These codes are CPT code 82397 for "chemiluminescent assay" and ICD-9 code, V76.42, which refers to a “special screening for malignant neoplasms, oral cavity”.  Either you or your dentist can submit medical claims to your medical insurance company.  Your medical insurance company can provide you with a claim form.

MSA/HSA Option

Medical Spending Accounts or MSAs, if offered by your employer, are an excellent option to use for reimbursement of your ViziLite Plus examination. Healthcare Savings Accounts, HSAs, can also be an option for reimbursement of your annual ViziLite Plus exam. In any case, be sure to get documentation of the ViziLite Plus exam from your dental office and submit a copy of this, along with your receipt, for reimbursement.

What if my claim is denied?

Zila Pharmaceuticals has also prepared sample appeal letters for you to send to your insurance company in the event that your submission for reimbursement has been denied.  Simply download the letter by clicking here (or request a letter by calling 866.945.2776), add your information to the letter, and forward it to your insurance company.

Other important considerations

It is also strongly recommended that you communicate to your employer the importance of the ViziLite Plus examination.  Then ask whether your employer's dental and/or medical benefits cover the ViziLite Plus exam.  Your input is very influential with your employer and could influence the coverage decisions that are made in conjunction with your employer's dental and medical insurance companies.  If you prefer to send a letter to your employer, click here to download a letter template, add your information, and then forward to your employer.