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.