icd 10 code for compression stockings above knee

A4490 Surgical stocking, above knee length, each A4495 Surgical stockings, thigh length, each A4500 Surgical Stocking, below knee length, each A4510 Surgical Stocking, full length, each A6530Gradient compression stocking, below knee, 18-30 mmHg, each A6531 Gradient compression stocking, below knee, 30-40 mmHg, each A6532 Gradient compression stocking, below knee, 40-50 mmHg, each A6533 Gradient compression stocking, below knee, 18-30 mmHg, each A6534 Gradient compression stocking, thigh length, 30-40 mmHg, each A6535 Gradient compression stocking, thigh length, 40-50 mmHg, each A6536Gradient compression stocking, full length, chap style 18-30 mmHg, each A6537 Gradient compression stocking, full length/chap style, 30-40 mmHg, each A6538 Gradient compression stocking, full length/chap style, 40-50 mmHg, each A6539 Gradient compression stocking, waist length, 18-30 mmHg each A6540 Gradient compression stocking, waist length, 30-40 mmHg, each A6541 Gradient compression stocking, waist length, 40-50 mmHg, each A6542 Gradient compression stocking, custom made A6543 Gradient compression stocking, lymphedema A6544 Gradient compression stocking, garter belt A6545 Gradient compression wrap, non-elastic, below knee, 30-50 mmHg each A6549 Gradient compression stocking, not otherwise specified

Full Answer

What is the CPT code for compression garments and stockings?

Compression Garments and Stockings Compression Garments and Stockings HCPCS Code range A6501-A6550 The HCPCS codes range Compression Garments and Stockings A6501-A6550 is a standardized code set necessary for Medicare and other health insurance providers to provide healthcare claims. Subscribe to Codify and get the code details in a flash.

Does Medicare pay for compression stockings?

Medicare coverage is limited to either 30-40mmHg Ready to Wear Circular Knit Compression Stockings, Knee High only ( HCPCS: A6531 ), and Gradient Compression Wrap, Non-Elastic, Below Knee, 30-50mmHg Velcro Compression Binders ( HCPCS A6545 ).

Does Medicare cover compression garments for lymphedema?

Without properly fitting compression garments patients with lymphedema continue to swell, are at risk for infections and hospitalization which will cost Medicare millions of dollars each year. Lymphedema patients must have correctly fitting compression garments at all times to independently manage their swelling.

What are the different types of compression bandages?

Light Compression Bandage (A6448-A6450), Moderate/High Compression Bandage (A6451, A6452), Self-Adherent Bandage (A6453-A6455), Conforming Bandage (A6442-A6447), Padding Bandage (A6441)

How do you code compression stockings?

The CPT Code for compression stockings are CPT A6531, CPT A6532, and CPT A6545 are noncovered for the following conditions:Venous insufficiency without stasis,Ulcers, prevention of stasis ulcers,Prevention of the reoccurrence of stasis ulcers that have healed,Treatment of lymphedema in the absence of ulcers.

What is code A6530?

HCPCS code A6530 for Gradient compression stocking, below knee, 18-30 mmHg, each as maintained by CMS falls under Compression Garments and Stockings .

What is the HCPCS code for gradient compression stockings?

A6530HCPCS 2018A6530Gradient compression stocking, below knee, 18-30 mmhg, eachA6541Gradient compression stocking, waist length, 40-50 mmhg, eachA6544Gradient compression stocking, garter beltA6545Gradient compression wrap, non-elastic, below knee, 30-50 mm hg, each11 more rows

What is CPT code A6549?

An unlisted compression code (ie A6549, Gradient compression stocking/sleeve, not otherwise specified) should not be used unless the medical documentation clearly shows that standard compression garments are unable to be custom fitted for the member and medical necessity is met.

What does CPT code A9270 mean?

In cases where there is no specific procedure code for an item or supply and no appropriate NOC code available, the HCPCS code A9270 must be used by suppliers to bill for statutorily non-covered items and items that do not meet the definition of a Medicare benefit. Carriers and DMERCs.

When should you wear compression stockings?

Your doctor may recommend you wear compression socks for:Boosting circulation in the legs.Decreasing swelling in the legs and ankles.Improving lymphatic drainage.Managing orthostatic hypotension, or low blood pressure when you stand up after a period of sitting down.Preventing blood from pooling in the leg veins.More items...

What is a gradient compression stocking?

Gradient compression stockings help return blood to your heart by compressing (squeezing) your leg muscles. This gently squeezes your veins and helps to push your blood in the right direction. • 'Gradient compression' means that the amount of compression in the stocking gradually changes.

Are compression garments considered DME?

A compression garment (stocking/burn garment/gradient pressure aid garment/sleeve) is a custom-made or custom-fitted elastic support garment that is fabricated to apply varying pressure gradients to an area. These garments are considered Durable Medical Equipment (DME).

Is A6531 covered by Medicare?

Medicare coverage is limited to either 30-40mmHg Ready to Wear Circular Knit Compression Stockings, Knee High only (HCPCS: A6531), and Gradient Compression Wrap, Non-Elastic, Below Knee, 30-50mmHg Velcro Compression Binders (HCPCS A6545).

What is CPT E1399?

HCPCS code E1399 describes “durable medical equipment, miscellaneous” and is currently being used to bill for inexpensive DME subject to the rules of 42 C.F.R. 414.220, other covered DME subject to the rules of 42 C.F.R.

Does Medicare cover A6549?

The remaining compression device codes - including A6549 – are listed on the Noridian web page for "Noncovered Items."[7] In addition, all remaining codes for gradient compression garments have been assigned the Medicare Status Indicator of "N", which is defined as "non-covered by Medicare."[8] The Medicare PDAC ...

Are compression stockings covered by insurance?

Many insurance plans cover treatment of edema and/or Deep Vein Thrombosis (DVT) with compression support socks. The best way to find out is by calling the insurance number found on your card.

What is CPT code a4465?

Short Description: Non-elastic extremity binder. Long Description: NON-ELASTIC BINDER FOR EXTREMITY.

What are HCPCS codes?

HCPCS is a collection of standardized codes that represent medical procedures, supplies, products and services. The codes are used to facilitate the processing of health insurance claims by Medicare and other insurers. HCPCS is divided into two subsystems, Level I and Level II.

What is the HCPCS code for ambulance waiting time 1 hour?

HCPCS Code Details - A0420HCPCS Level II Code Transportation Services Including Ambulance, Medical & Surgical Supplies SearchHCPCS CodeA0420DescriptionLong description: Ambulance waiting time (als or bls), one half (1/2) hour increments Short description: Ambulance waiting 1/2 hrHCPCS Modifier19 more rows•Jan 1, 1995

What are CPT appendices?

Appendix N is a list of CPT codes that do not appear in their respective numerical sequence in the listing in the CPT book. The resequenced codes will be located near but not in proper numerical sequence. This appendix is included to avoid deleting and having to renumber a series of codes to fit in a new one.

What is the 10th revision of the ICD-10?

ICD – 10 ICD – 10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems ( ICD ), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs, and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases.

What is HCPCS in medical terms?

The Healthcare Common Procedure Coding System (HCPCS, often pronounced by its acronym as “hick picks”) is a set of health care procedure codes based on the American Medical Association’s Current Procedural Terminology (CPT).

Does Medicare cover compression garments?

Medicare Policy for Compression Garments. Hard to believe but Medicare does NOT cover most compression garments. Medicare may cover cancer surgery, therapy for lymphedema, and other swelling disorders but when it comes to Medicare covering compression garments, 99% of Medicare recipients will have to pay out of their own pocket.

What is CMS in healthcare?

The Centers for Medicare & Medicaid Services (CMS), the federal agency responsible for administration of the Medicare, Medicaid and the State Children's Health Insurance Programs, contracts with certain organizations to assist in the administration of the Medicare program. Medicare contractors are required to develop and disseminate Local Coverage Determinations (LCDs). CMS believes that the Internet is an effective method to share LCDs that Medicare contractors develop. While every effort has been made to provide accurate and complete information, CMS does not guarantee that there are no errors in the information displayed on this web site. THE UNITED STATES GOVERNMENT AND ITS EMPLOYEES ARE NOT LIABLE FOR ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION, PRODUCT, OR PROCESSES DISCLOSED HEREIN. Neither the United States Government nor its employees represent that use of such information, product, or processes will not infringe on privately owned rights. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information, product, or process.

What are the requirements for Medicare?

For any item to be covered by Medicare, it must 1) be eligible for a defined Medicare benefit category, 2) be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member, and 3) meet all other applicable Medicare statutory and regulatory requirements.

Does Medicare cover surgical dressings?

Medicare provides reimbursement for surgical dressing under the Surgical Dressings Benefit. This benefit only provides coverage for primary and secondary surgical dressing used on the skin on specified wound types. Refer to the related Policy Article NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES for information about these statutory requirements.

Can you use CPT in Medicare?

You, your employees and agents are authorized to use CPT only as contained in the following authorized materials of CMS internally within your organization within the United States for the sole use by yourself, employees and agents. Use is limited to use in Medicare, Medicaid or other programs administered by the Centers for Medicare and Medicaid Services (CMS). You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.

How many replacements are needed for compression stockings?

For pressure gradient support stockings, no more than 4 replacements per year are considered medically necessary for wear.

What is compression garment?

Compression garments are usually made of elastic material, and are used to promote venous or lymphatic circulation. Compression garments worn on the legs can help prevent deep vein thrombosis and reduce edema, and are useful in a variety of peripheral vascular conditions.

Why are OTC stockings not covered?

Note: These OTC stockings are also not covered because they are not primarily medical in nature. Silver impregnated compression stockings are considered not medically necessary because there is insufficient evidence that silver impregnated compression stockings are superior to standard compression stockings.

How does compression garment help athletes?

Compression garments (CG) have been shown to improve performance in athletes by increasing venous return and reduce lactic acid. These researchers evaluated the effect of CG on the performance of 3 standardized functional tests in persons with PD.

Why are compression garments considered experimental and investigational?

Compression garments are considered experimental and investigational for members with severe peripheral arterial disease or septic phlebitis because they are contraindicated in these conditions.

Is compression garment considered experimental?

These compression garments for the legs are considered experimental and investigational for all other indications ( e.g., improvement of functional performance in individuals with Parkinson disease, improvement of knee proprioception in rehabilitation setting, management of delayed-onset muscle soreness, management of pain during post-natal care, and management of spasticity following stroke).

Does Aetna cover compression stockings?

Note: Aetna's standard benefit plans do not cover graded compression stockings or non-elastic binders because they are considered an outpatient consumable or disposable supply. Please check benefit plan descriptions for details.