Advanced Vascular Technologies has years of experience in providing Lymphedema Compression Pumps.
We know what is covered by which Insurance companies, and what is not. We also know what you, as the medical professional needs to accomplish to get your patient the right equipment. We will work with you to make sure that you keep the right records. We will walk you through the process to help take care of your patients.
New ICD-10 codes as of 10/1/15
- 457.1 converts to I89.0 – Lymphedema, not elsewhere classified.
- 457.0 converts to I97.2 – Post mastectomy lymphedema syndrome.
- 757.0 converts to Q82.0 – Hereditary lymphedema
- 459.81 converts to I87.2 – Venous Insufficiency (chronic) (peripheral)
- 459.31 converts to I87.319 – Chronic venous hypertension (idiopathic) with ulcer of unspecified lower extremity.
- 707.12457.1 converts to I89.0 – Lymphedema, not elsewhere classified.
- 454.0 converts to the following:
- I83.009 – Varicose veins of unspecified lower extremity with ulcer of unspecified area.
- I83.019 – Varicose veins of right lower extremity with ulcer of unspecified site.
- 83.029 – Varicose veins of left lower extremity with ulcer of unspecified site.
- 707.10 converts to L97.909 – Non-pressure ulcer of unspecified part of unspecified lower leg unspecified severity.
- 707.11 converts to L97.109 – Non-pressure chronic ulcer of unspecified thigh with unspecified severity.
- 707.12 converts to L97.209 – Non-pressure ulcer of unspecified calf with unspecified severity.
- 707.13 converts to L97.309 – Non-pressure chronic ulcer of unspecified ankle with unspecified severity.
- 707.14 converts to L97.409 – Non-pressure chronic ulcer of unspecified heel and mid-foot with unspecified severity.
- 707.15 converts to L97.509 – Non-pressure chronic ulcer of other part of unspecified foot with unspecified severity.
- 707.19 converts to L97.809 – Non-pressure chronic ulcer of other part of unspecified lower leg with unspecified severity.
These new codes must be used on all CMNs, and they must match the codes that you use in your Clinical notes, and records. There will be hangups, and screw ups during the transition. We ask for your understanding during the changeover.
Medicare has made things more complicated over the years. You are most likely aware of the ” Face to Face ” rules. Medicare requires that you physically see a patient at least six months prior to prescribing any medical equipment. Medicare and most insurance companies require detailed clinical notes as to why your patient needs medical equipment. Letters of Medical Necessity used to be accepted many insurance companies, but not any longer. Detailed medical records are a must for every insurance company. As a rule, we tell physicians that they should never assume that the administrator at the insurance company will look at a record and extrapolate that a patient has done the most basic, conservative treatments. Most miss details in the records that jump out to even junior medical professional. So, make notes on everything.
To get a Lymphedema Compression Pump for a patient, most insurance companies require that the patient has tried to deal with the Lymphedema with the use of a compression stocking. If the patient cannot wear a stocking for what ever reason, your records needs to state that. It is an important fact that needs to be there. If the patient is so morbidly obese that they cannot reach their feet, then say that. If they have a bad back, and cannot apply a stocking alone, say that your dictation. Medicare is notorious for denying a Compression Pump on the lack of stocking use alone.
The general rule of thumb these days is, the more detailed notes the better.