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1. CPT CODE FOR INTERMITTENT PNEUMATIC COMPRESSION DEVICE MANUAL
2. CPT CODE FOR INTERMITTENT PNEUMATIC COMPRESSION DEVICE TRIAL

The determination by the physician of the medical necessity of a PCD device must include: monitor use and response to treatment on an ongoing basis.provide a treatment plan defining the pressure to be used and the frequency and duration of use.assure suitable instruction in the operation of the machine.evaluate the patient’s condition to determine medical necessity of the device.Medicare covers PCDs only when prescribed by a physician when the physician uses appropriate oversight to:

CPT CODE FOR INTERMITTENT PNEUMATIC COMPRESSION DEVICE MANUAL

The only time Medicare covers a segmented, calibrated gradient PCD (HCPCS code E0652) is when the individual has unique characteristics that prevent them from receiving satisfactory pneumatic compression treatment using a non-segmented device in conjunction with a segmented appliance or a segmented compression device without manual control of pressure in each chamber.

CPT CODE FOR INTERMITTENT PNEUMATIC COMPRESSION DEVICE TRIAL

The trial of conservative therapy must include a compression bandage system or compression garment, appropriate dressings for the wound, exercise, and elevation of the limb. Medicare covers PCDs in the home setting for the treatment of CVI of the lower extremities only if the patient has one or more venous stasis ulcer(s) which have failed to heal after a 6-month trial of conservative therapy directed by the treating physician. The garment may be prefabricated or custom-fabricated but must provide adequate graduated compression. The trial of conservative therapy must include use of an appropriate compression bandage system or compression garment, exercise, and elevation of the limb. Medicare covers PCDs in the home setting for the treatment of lymphedema if the patient has undergone a 4-week trial of conservative therapy and the treating physician determines that there has been no significant improvement or if significant symptoms remain after the trial. Signs of CVI include hyperpigmentation, stasis dermatitis, chronic edema, and venous ulcers. ( LCD 元3829)Ĭhronic Venous Insufficiency (CVI) of the lower extremities is a condition caused by abnormalities of the venous wall and valves, leading to obstruction or reflux of blood flow in the veins.

Secondary lymphedema may also result from compression of the lymphatic and venous channels resulting from leakage of fluid into interstitial tissues in patients with chronic venous insufficiency. ( NCD 280.6) It is most commonly caused by surgery (especially lymph node dissection, such as for breast cancer), radiation therapy (especially axillary or inguinal), trauma, lymphatic obstruction by tumor, and, in developing countries, lymphatic filariasis. Secondary lymphedema, which is much more common, results from the destruction of or damage to formerly functioning lymphatic channels, such as surgical removal of lymph nodes or post radiation fibrosis, among other causes. Primary lymphedema is a relatively uncommon, chronic condition which may be due to such causes as Milroy's Disease or congenital anomalies. Lymphedema is divided into two broad classes according to etiology. The accumulation of lymph fluid results from impairment to the normal clearing function of the lymphatic system and/or from an excessive production of lymph. Lymphedema is the swelling of subcutaneous tissues due to the accumulation of excessive lymph fluid. ( See the National Coverage Determination Manual (NCD) 280.6) Medicare covers pneumatic devices for the treatment of lymphedema or for the treatment of Chronic Venous Insufficiency (CVI) with venous stasis ulcers. The garment is intermittently inflated and deflated with cycle times and pressures that vary between devices. Pneumatic compression devices consist of an inflatable garment for the arm or leg and an electrical pneumatic pump that fills the garment with compressed air.