Medicare Therapy Coverage For Lymphedema
- October 20, 2017
- Posted by: marlenedubois
- Category: Nursing Assistant Classes
Getting Medicare to recognize lymphedema therapy as essential medical expenditure has been a difficult task. Lymphedema patients have been long trying to get the benefit of Medicare for the expenses of which they incur for the therapy of which continues throughout their life. The Women’s Health along with Cancer Rights Act states of which complications arising due to breast cancer surgery, which includes lymphedema, must be covered by all insurance providers. However, This specific coverage does not extend to those who suffer by primary or secondary lymphedema. In February 2008, the compression garments considered an essential part of lymphedema therapy were classified as covered items for Medicare.
Lymphedema is usually a condition of which has no medical cure, although of which can be managed with therapy which is usually known as the Complete Decongestive Therapy or CDT. The process involves a lymphatic massage combined with the use of compression bandages along with compression garments, a skin care routine along that has a regular exercise regimen. The most important aspect of the therapy is usually the manual lymph drainage (MLD) which aims at draining the stagnated lymph to reduce the swelling. Occasionally, the therapist might use the Sequential Gradient Pump to loosen fibrotic tissues before the massage. The therapist performing the lymphatic massage is usually a specialized professional trained inside the technique. Therapy sessions inside the early stages may be held frequently, at least several days a week. Those who do not have easy access to the lymphedema therapist may use a sequential gradient pump for the lymphatic drainage process.
Medicare covers the lymphedema pump therapy, nevertheless recently the coverage rules have been modified. Previously, although the pneumatic compression devices were included in coverage, the patient had to attempt all some other methods of treatment first, a process of which took many months. This specific has changed right now. Compression devices have been included under durable medical expenses for both primary along with secondary lymphedema. There is usually a four-week trial period which the doctor must observe. A course of medication, use of compression garments along with elevation of the limb is usually followed by the patient along with if no improvement is usually seen, the doctor prescribes a pneumatic pump. The doctor is usually required to give a Certificate of Medical Necessity to enable the patient to procure a lymphedema pump by a Medicare authorized supplier. The supplier of the pump must be enrolled with Medicare along with possess the Medicare Supplier Number, or you will not be reimbursed the claim.
In case of compression garments, which can be a large recurring expense, lymphedema sufferers have had to deal with legislatures which prevented their inclusion in Medicare coverage lists. A positive judgment in February 2008 has come to the aid of lymphedema patients. Compression garments were classified as items meeting the standards for covered items. Items like compression bandages, compression sleeves along with stockings were considered medically essential along with might be covered as prosthetic devices under Medicare for lymphedema therapy. The lymphedema patients can take advantage of This specific edict along with claim a compensation for these medically essential items of which help them to manage the lymphedema.