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