COMPRESSION/PRESSURE STOCKINGS AND SUPPORT HOSE

A Physician Order/Statement of Medical Necessity is NOT required for stockings unless criteria are met.

Gradient compression stockings that serve a therapeutic or protective function and that are needed to secure a primary dressing may be covered as surgical dressings. Stockings must be proven to deliver compression > 30 mm Hg. and < 50 mm Hg.

Medicare limits the coverage and reimbursement of gradient compression stockings to the following situation:

- The beneficiary must have an open venous stasis ulcer that has been treated by a physician or other healthcare professional requiring medically necessary debridement.

Reimbursement is not covered for:

- Venous insufficiency without stasis ulcers

- Prevention of stasis ulcers,

- Prevention of the reoccurrence of stasis ulcers that have healed

- Treatment of lymphedema in the absence of ulcers

Chart notes are required and documentation must reflect qualifying criteria.