What is a gradient sleeve?
A compression garment (stocking/burn garment/gradient pressure aid garment/sleeve) is a typically fitted elastic support garment that is fabricated to apply varying pressure gradients to an area. These garments are considered Durable Medical Equipment (DME).
What is CPT A6545?
HCPCS code description: Gradient compression wrap, non-elastic, below knee, 30-50 mm hg, each.
Does Medicare cover A6545?
Under Medicare guidelines A6545 falls under the category of surgical dressings, and is covered when used in the treatment of open venous stasis ulcer. Medicare has set a limit of one compression wrap per 6 months per leg.
What is CPT code A6549?
Gradient compression stocking
HCPCS code A6549 for Gradient compression stocking/sleeve, not otherwise specified as maintained by CMS falls under Compression Garments and Stockings .
What is a gradient compression wrap?
Gradient compression garments are typically two-way stretch knit that can be used to treat conditions such as; chronic venous insufficiency, venous stasis ulcers and lymphedema. Non-elastic gradient compression wraps and binders work in a similar manner as, and can be an alternative to, gradient compression stockings.
What are gradient compression stockings?
Gradient compression stockings provide graduated compression, where the pressure is higher towards the ankle and decreases as the stocking goes up. Patients who use gradient compression stockings are ambulatory, meaning they can walk freely as opposed to being confined to the bed. …
Does Medicare cover Circaid wraps?
Non-elastic gradient compression wrap below the knee, 30-50 mm hg is covered by Medicare Part B when it is used in the treatment of an open venous stasis ulcer. Medicare has guidelines that establish what is considered medically necessary and how often an item can be used.
Does Medicare cover physical therapy for lymphedema?
Lymphedema is often considered an “out-of-capitation” or “out-of-network” service. You may be allowed to attend any facility with the assistance of your PCP to obtain an ‘out-of-network referral’ from your insurance company. Medicare covers PT/OT visits with no financial limit on services that are medically necessary.
What does Aw modifier mean?
Modifier AW Any claims submitted with a identified above that does not have the appropriate modifier appended as per the policy with which it is billed, will be denied as noncovered.
What is the CPT code for lymphedema?
Medically necessary hands-on MLD is a covered Medicare service and is coded using CPT® 97140 for manual therapy. There is no Medicare coverage for lymphedema compression bandage application as this is considered to be an unskilled service.
What is a non-elastic binder for extremity?
Non-elastic binders are composed of material that is fastened with adjustable Velcro, hooks, loops or other straps to provide compression. Gradient compression garments may be custom-fitted or custom fabricated.
How do I bill A6545?
Instead, the A6545 code must have an -AW modifier appended to it (Item furnished in conjunction with a surgical dressing.). The -AW modifier should only be used with codes for certain compression garments, including EXTREMIT-EASE, and tape codes A4450 and A4452.