Compression Guidelines
Compression Billing Guidelines
Medicare will pay for compression products in certain cases.
Who is eligible for covered compression products?
- Patients diagnosed with Lymphedema
- Patients with an open debrided venous stasis ulcer
What products can be ordered?
- Compression garments, including those for daytime and nighttime, which offer different levels of compression
- Compression bandaging systems and supplies provided during the initial decongestion phase and maintenance phases of treatment
- Gradient compression wraps with adjustable straps
- Necessary accessories for gradient compression garments and wraps
*Ordering provider must provide the actual size of the compression system they are requesting when applicable OR provide measurements of calf, ankle and length (bottom of foot to back of knee).
How Often?
1. Lymphedema patients
- Daytime: 3 garments per affected body part every 6 months
- Nighttime: 2 garments per affected body part every 2 years
2. Open debrided venous stasis ulcer patients
- One compression garment per leg every 6 months with a venous stasis ulcer present
- One multi-layer compression system up to twice weekly
*If no debrided venous stasis ulcer is present, the chart notes MUST specify a record of Lymphedema diagnosis, the impacted extremity location and the plan of care must mention compression for treatment.