Proper L codes for compression hose/sleeves RESPONSES
Randy McFarland
Description
Collection
Title:
Proper L codes for compression hose/sleeves RESPONSES
Creator:
Randy McFarland
Date:
11/1/2010
Text:
ORIGINAL POST
Although I know that the lower compression elastic garments are not covered
by Medicare, please clarify what the recommended L codes are upper and lower
extremity compression hose for both custom and off the shelf compression
garments. Randy McFarland, CPO
RESPONSES
Medicare does cover compression garments for below the knee and above the
knee. You must have venous stasis ulcer diagnosis, Rx has to be for
30-40mmHg. Will not cover any custom items or upper extremity ones. There
are only 2 codes you can use, in lowers, sorry, I am at home and do not have
L-code book on me, but it's pretty straightforward from now on.
Medicare moved compression garments from L codes to A codes. They are still
identified as below knee, above knee and arm sleeve compression garments at
the 3 compression levels. For example a6530 is a 20/30 mm hg below knee
stocking.
Actually they may be covered if used for an open wound.
You should consider calling the manufacturer and asking for the recommended
L-Code and confirm with PDAC. We got the correct Burn Garment code that way,
then confirmed that it was an active code.
It is my understanding no upper extremity C-hose are covered. Neither are
custom items or anything but knee length 30-40mm hose.
for lower extremity stockings the A codes are most appropriate A6530 (20-30
below knee stockings) through A6549 (misc code for non otherwise specified
lower limb) for upper extremity L8010 for lymphedema sleeve and E1399 for
the had gauntlet hope this helps
Although I know that the lower compression elastic garments are not covered
by Medicare, please clarify what the recommended L codes are upper and lower
extremity compression hose for both custom and off the shelf compression
garments. Randy McFarland, CPO
RESPONSES
Medicare does cover compression garments for below the knee and above the
knee. You must have venous stasis ulcer diagnosis, Rx has to be for
30-40mmHg. Will not cover any custom items or upper extremity ones. There
are only 2 codes you can use, in lowers, sorry, I am at home and do not have
L-code book on me, but it's pretty straightforward from now on.
Medicare moved compression garments from L codes to A codes. They are still
identified as below knee, above knee and arm sleeve compression garments at
the 3 compression levels. For example a6530 is a 20/30 mm hg below knee
stocking.
Actually they may be covered if used for an open wound.
You should consider calling the manufacturer and asking for the recommended
L-Code and confirm with PDAC. We got the correct Burn Garment code that way,
then confirmed that it was an active code.
It is my understanding no upper extremity C-hose are covered. Neither are
custom items or anything but knee length 30-40mm hose.
for lower extremity stockings the A codes are most appropriate A6530 (20-30
below knee stockings) through A6549 (misc code for non otherwise specified
lower limb) for upper extremity L8010 for lymphedema sleeve and E1399 for
the had gauntlet hope this helps
Citation
Randy McFarland, “Proper L codes for compression hose/sleeves RESPONSES,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/232036.
