Responses: compression garment question

Responses: compression garment question

Craig R. DeCamp

7/21/2009

Once again the listserve has answered my question: Does Medicare cover
compression garments?

 

I received about a dozen responses and the following one summarizes them all
and is well defined.

 

Thanks to everyone,

 

 

Craig R. DeCamp

Board Certified Orthotist & Prosthetist

 <mailto:<Email Address Redacted>> <Email Address Redacted>

 

  _____

From: Lisa Malespin [mailto:<Email Address Redacted>]
Sent: Monday, July 20, 2009 4:01 PM
To: <Email Address Redacted>
Subject: answer to your compression garment question

 

Hi Craig,

I am a compression garment fitter with 7 years experience and I can answer
your question.

 

Medicare will only consider coverage for compression stockings as follows:

The Lcode must be A6531 (30-40 mmHg Below Knee)

The stockings must be below knee style

The prescription must state that these are treatment of Open Venous Stasis
Ulcers and the diagnosis code should be: 707.10

When billing out it must have the AW modifier that identifies that it is
covered (meets all the criteria described above)

 

I understand your confusion on this subject. If the doctor prescribes 20-30
mmhg and the correct diagnosis code, it will not be covered. The key here
is the correct Lcode of A6531 and the correct diagnosis code of 707.10, if
they are not on the prescription, don't bother submitting to Medicare.

 

I always explain to my patient's that I will collect from them up front and
will submit to their Medicare if their prescription has the correct info, it
will be up to Medicare to consider payment and if they pay the claim, the
patient will be reimbursed by Medicare.

 

Hope this helps.

 

Lisa Malespin, C.F.O.M

 

Brownfield's Prosthetic & Orthotic Technologies, Inc.

122 N. 5th Street

Boise, Idaho 83702

(208) 342-4659 ext. 1012 Fax: (208) 342-8211

<Email Address Redacted>

 < <URL Redacted>> www.brownfieldstech.com