Local Coverage Article Billing and Coding

Billing and Coding: High Compression Bandage System Clarification

A52768

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Contractor Information

Article Information

General Information

Article ID
A52768
Article Title
Billing and Coding: High Compression Bandage System Clarification
Article Type
Billing and Coding
Original Effective Date
10/01/2015
Revision Effective Date
04/29/2020
Revision Ending Date
N/A
Retirement Date
N/A
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Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

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CMS National Coverage Policy

N/A

Article Guidance

Article Text

Multi-layered, sustained, graduated, high compression bandage systems are used primarily to treat lymphedema and venous or stasis leg ulcers. A number of graduated, high-compression bandage systems products have been developed, including Profore®, Dyna-Flex®, Surepress®, Setopress®, and other similar product systems.

Providers should note that the treatment of lymphedema with the application of high compression bandage systems continues to be non-covered by Medicare. However, a brief period, i.e. three or fewer sessions if no new specific issues are identified, of patient and/or caregiver education for home management of lymphedema with compression wrap applications may be medically necessary and reimbursable. Medical necessity for the education must be clearly indicated in the patient's record and must meet the code descriptor requirements for CPT 97535, supporting home management training.

Following review of the current literature, the practices of our providers, and the January 2012 implementation of the specific CPT codes describing the application of multi-layered compression bandage systems, Noridian will cover and separately reimburse the costs of the following procedures for non-lymphedema applications that meet Medicare coverage requirements:

• 29581 - Application of multi-layer compression system; leg (below knee), including ankle and foot
• 29584 - upper arm, forearm, hand, and fingers

Notes:

• 97140 - Should not be reported for any type of manual therapy provided during the same patient encounter in the same anatomic region where a multi-layer compression system is applied.
• 97597 - Should not be reported with casting/splinting/strapping
(29580 or 29581) for the same anatomic area.

Resource:

• National Correct Coding Initiative (NCCI) Policy Manual Hospital APC Version 19.2, Chapter IV, Part F, Sections 3 and 15

Coding Information

CPT/HCPCS Codes

Group 1

(6 Codes)
Group 1 Paragraph

N/A

Group 1 Codes
CodeDescription
29580 STRAPPING; UNNA BOOT
29581 APPLICATION OF MULTI-LAYER COMPRESSION SYSTEM; LEG (BELOW KNEE), INCLUDING ANKLE AND FOOT
29584 APPLICATION OF MULTI-LAYER COMPRESSION SYSTEM; UPPER ARM, FOREARM, HAND, AND FINGERS
97140 MANUAL THERAPY TECHNIQUES (EG, MOBILIZATION/ MANIPULATION, MANUAL LYMPHATIC DRAINAGE, MANUAL TRACTION), 1 OR MORE REGIONS, EACH 15 MINUTES
97535 SELF-CARE/HOME MANAGEMENT TRAINING (EG, ACTIVITIES OF DAILY LIVING (ADL) AND COMPENSATORY TRAINING, MEAL PREPARATION, SAFETY PROCEDURES, AND INSTRUCTIONS IN USE OF ASSISTIVE TECHNOLOGY DEVICES/ADAPTIVE EQUIPMENT) DIRECT ONE-ON-ONE CONTACT, EACH 15 MINUTES
97597 DEBRIDEMENT (EG, HIGH PRESSURE WATERJET WITH/WITHOUT SUCTION, SHARP SELECTIVE DEBRIDEMENT WITH SCISSORS, SCALPEL AND FORCEPS), OPEN WOUND, (EG, FIBRIN, DEVITALIZED EPIDERMIS AND/OR DERMIS, EXUDATE, DEBRIS, BIOFILM), INCLUDING TOPICAL APPLICATION(S), WOUND ASSESSMENT, USE OF A WHIRLPOOL, WHEN PERFORMED AND INSTRUCTION(S) FOR ONGOING CARE, PER SESSION, TOTAL WOUND(S) SURFACE AREA; FIRST 20 SQ CM OR LESS

CPT/HCPCS Modifiers

N/A

ICD-10-CM Codes that Support Medical Necessity

N/A

ICD-10-CM Codes that DO NOT Support Medical Necessity

N/A

Additional ICD-10 Information

N/A

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

N/A

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

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Other Coding Information

N/A

Revision History Information

Revision History DateRevision History NumberRevision History Explanation
04/29/2020 R4

Converted to billing and Coding article and added 29580, 29581, 29584, 97140, 97535 and 97597 to the  CPT/HCPCS Codes section. No change in coverage was made.

01/01/2018 R3

Effective 01/01/2018 deleted the following CPT codes from the article text and Group 1.

  • 29582
  • 29583
12/29/2016 R2 This article is revised to combine JF Part A (JFA) Local Coverage article A52752 into the JF Part B (JFB) article A52768 so that both JFA and JFB contract numbers will have the same final MCD article number as JFB effective 12/29/16.
10/01/2015 R1 The wording in this article was changed, however coverage guidance was not changed.

Associated Documents

Related Local Coverage Documents
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Related National Coverage Documents
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Statutory Requirements URLs
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Rules and Regulations URLs
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CMS Manual Explanations URLs
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Other URLs
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Public Versions
Updated On Effective Dates Status
01/13/2021 04/29/2020 - N/A Currently in Effect You are here
Some older versions have been archived. Please visit the MCD Archive Site to retrieve them.

Keywords

  • High
  • Compression
  • Bandage
  • 29581
  • 29584