CMS has called this meeting for the panel to discuss the adequacy of the available evidence that supports the diagnostic and treatment methods used in the management of secondary lymphedema. Medicare currently has a national coverage determination for the use lymphedema pumps related to the treatment of this condition.
Lymphedema occurs due to dysfunction of the lymphatic transport system. As a result of this abnormality, fluid (containing mostly water, protein, fatty acids, white blood cells, salts and debris/microorganisms) accumulates within the interstitial tissue of various areas of the body. The fluid accumulation can cause subclinical disease (that which cannot be seen on clinical examination) to gross enlargement of a body part. Complications of lymphedema include intradermal fibrosis, infection, pain and impaired functioning of the affected body part.
Lymphedema can be classified as either primary (due to abnormal development or growth of the lymphatic system) or secondary (due to injury to the lymphatic system). In the United States, the most common form of secondary lymphedema is that associated with the surgery and radiation of cancer treatment.
Strategies for the treatment of secondary lymphedema are directed at preventing or minimizing the fluid accumulation in the affected body parts, restoring any lost function and providing education to avoid the potential of anticipated complications.