Monday, May 15, 2006

Lymphedema Legislation Alert

Sending this to all my groups - important we act on this



Robert Weiss, MS, NLN Legislative Patient Advocate

The recent change to the HCPCS coding of compression garments is a change that will have devastating impact on treatment of lymphedema patients in this country. By re-classifying these garments as "surgical dressings, secondary" they will no longer be covered for home use, and can no longer be billed as prosthetics (L-Code) and allowable under section 1861(s)(8) of the Social Security Act. This Medicare action will deprive an estimated 1.3-million lymphedema sufferers under Medicare, and by extension, other millions under HMO or private insurance, of the medically necessary treatment tool required in the daily care of their lymphedema.

I have already heard from one Medicare "beneficiary" who, after many years of receiving compression garments for his lymphedema, was notified that he will no longer receive compression garments for treatment of his lymphedema, based on the recent code change.

We must write to our Congressional representatives protesting this change of coding which has no basis either in Medicare law or medicine, which was not opened to medical or legal discussion, and which will potentially result in an increase in Medicare costs to treat cellulitis resulting from under-treatment of lymphedema. A National Coverage Decision on the subject of lymphedema treatment is long overdue. Also ask them whether they have considered sponsoring the "Lymphedema Diagnosis and Treatment Cost Saving Bill" which has been proposed widely in Washington over the last four years by this writer.

For questions or concerns, please contact Robert (“Bob”) at

No comments: