To Whom It May Concern: ______Insurance carrier______
This is to certify that
________your name________ is a patient of mine.
He/she is being
treated for recurrent major depressions with a seasonal pattern.
Referral to "seasonal patterns of depression" has been included in the most
recent revision of the Diagnostic and Statistical Manual of Mental
Disorders (DSM IV). Phototherapy is no longer considered experimental,
but is a mainstream type of psychiatric treatment for Seasonal Affective
Disorder (SAD). According to the December 8, 1993 issue of The
Journal of the American Medical Association (JAMA), "For many patients
with SAD, light therapy should be regarded as a first-line treatment,
given its high success and acceptance rate" (Vol. 270, No. 22, pages 2717-2720).
In 1989, the American Psychiatric Association's Task Force on Treatment of Psychiatric
Disorders (Vol. 3, pages 1890-1986, A.P.A. Press), recommended light therapy
as treatment for the range of clinical depression diagnoses, including:
Code Number | Diagnosis |
DSM IV-296.3x | Major Depression, Recurrent |
DSM IV-296.4x | Bipolar Disorder, most recent episode-Manic |
DSM IV-296.5x | Bipolar Disorder, Depressed |
DSM IV-296.6x | Bipolar Disorder, Mixed |
DSM IV-296.70 | Bipolar Disorder, NOS |
DSM IV-311.00 | Depressive Disorder, NOS |
In the case of ________your name________,
in order to administer phototherapy adequately, a bright light unit is
required and the use of the bright light unit should be regarded as a medical
necessity and preferable to other forms of treatment.
These procedures conform to April, 1993 U.S. Public Health Service-Agency for
Health Care Policy and Research guidelines for management of this disorder.
Publication # | Publication Title |
AHCPR93-0551 | Depress: Guideline Vol. 2 |
AHCPR93-0553 | Depress: Patient Guide |
Sincerely,
Your doctor's signature____________
Your doctor's address, etc.________
Date_______________________________
|