Medicare coverage of Lymphedema Garments, Bandages and Suppl

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Medicare coverage of Lymphedema Garments, Bandages and Suppl

Postby patoco » Fri Apr 13, 2007 1:21 pm

Dear Members

I just received this from Belisse Lymphedema
and wanted to pass it along




Medicare coverage of Lymphedema Garments, Bandages and Supplies!

Press Release

Hello friends,

Bellisse would like to share urgent news about a movement to acquire unique codes needed for products used by lymphedema patients in order to facilitate insurance claims. Many of you know the struggle we go through trying to get these unique products covered by insurers, and how Medicare refuses to cover any of the needed bandages, supplies and garments.

Bob Weiss, an activist for the cause has made headway in getting the attention of CMS (the government agency that creates these codes). This winter he was able to meet with many members of CMS and lay out the needs for this patient population. But the preliminary indication is that the request for new codes will be rejected. Recently we received an email explaining that Bob will be testifying at a public hearing May 1 to try to turn this decision around. We are sharing the information Bob sent to us later in this message.

How can you help?

If you can't attend the hearing, please make your concerns known by mail!

Letters can be sent to:
HCPCS Workgroup at CMS
7500 Security Boulevard
Baltimore, MD 21244
Refer to HCPCS Code Change Request #07-109

Please comment on only the issues that were cited as reasons for the preliminary rejection of the coding change request:

"No insurer (i.e., Medicare, Medicaid, Private Insurance Sector) identified a national program operating need to establish unique codes to distinguish all the products listed in this application. Existing codes adequately describe the array of products available."
We have heard from you that there IS a need for unique codes - currently, there is no truly appropriate category into which these unique compression products fall, and the current codes are not adequate to describe the various different garments in the compression product line. This results in difficulty in getting adequate and appropriate reimbursement for patients' expenses because there does not appear to be a good way to bill for their garment. We must use a "miscellaneous" code because there is no unique code that is appropriate. This all leads to many patients not getting the appropriate therapeutic garments they need!

This is our chance to be heard! Please take a moment and write now - PLEASE share this email with every lymphedema patient, health care provider or medical supplier you know - if we don't succeed, we will have to wait at least another year to try again!


Pat O'Connor
Lymphedema People

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