LYMPHEDEMA
Lymphedema is the swelling of subcutaneous tissue due to an accumulation of excessive lymph fluid resulting from an impairment of functioning lymph nodes or channels. Lymphedema is divided into two categories: A) Primary lymphedema may be congenital and is defined as praecox when the first manifestation occurs before age 15 and tarda when it appears after this age. B) Secondary lymphedema develops when lymph nodes or channels are damaged or destoyed during surgery, radiation, trauma, and or blood clot formation.
Pneumatic compression devices are covered for the treatment of chronic lymphedema if the treating physician determines there has been no improvement after a four-week trial of conservative therapy that includes exercise, elevation, bandages, and or compression stockings.
CHRONIC VENOUS INSUFFICIENCY WITH STASIS ULCERS
Chronic venous insufficiency (CVI) of the lower extremities is caused by incompetent valves leading to reflux of blood flow. Signs of CVI include hyperpigmentation, stasis dermatitis, chronic edema, and venous stasis ulcers.
Pneumatic compression devices are covered for the treatment of CVI if the patient has one or more venous stasis ulcer(s) which have failed to heal after six months of conservative therapy that included elevation, exercise, wound care dressings, compression bandages, or compression stockings. (There are no time requirements with private insurance carriers.)