The 2024 Lymphedema Treatment Act (LTA) transformed how lymphedema compression garments are classified, covered, and billed. In light of these changes, Compression Solutions now offers a comprehensive medical billing service to support healthcare providers and patients.
This article outlines what healthcare providers and administrators need to know to ensure optimal patient care and proper reimbursement for lymphedema compression garments.
Understanding the New Classification
The LTA has reclassified compression devices as durable medical equipment (DME), marking a fundamental shift in how these essential treatment tools are categorized within the healthcare system.
This reclassification enables Medicare coverage for compression garments and supplies for Medicare Part B participants who have received a clinical diagnosis of lymphedema.
Changes in Lymphedema Treatment Act Billing
Under the new guidelines, Medicare now covers specific quantities of compression garments with defined replacement schedules. Patients can receive three daytime garments or wraps per affected body area every six months. Additionally, two nighttime garments per body area are covered once every two years.
This standardization of coverage periods helps providers plan long-term treatment strategies for their patients while ensuring consistent access to necessary medical supplies.
Lymphedema Treatment Act Billing Documentation Requirements
To ensure coverage under the new guidelines, healthcare providers must maintain precise documentation in patient medical records. The requirements include a face sheet, signed order form, and comprehensive progress notes that document:
- Medical diagnosis: must be clearly stated using appropriate ICD-10 codes such as Lymphedema not elsewhere classified (189.0), Hereditary Lymphedema (Q82.0), Postmastectomy Lymphedema Syndrome (197.2), or Other postprocedural complications and disorders of the circulatory system (197.89).
- Recommended compression level: in millimeters of mercury (mmHg), based on the patient’s clinical needs and condition severity.
- Length of Need: The duration of the disease, whether less than six months, six to twelve months, one to two years, or greater than two years.
- Stage of lymphedema: ranging from Stage 0 (no visible edema) through Stage 3 (severe edema with skin changes).
Streamlined Billing Solutions for Healthcare Providers
To streamline Lymphedema Treatment Act billing requirements, Compression Solutions has introduced a comprehensive billing service to support healthcare providers.
Its team of medical billing experts handles all aspects of the reimbursement process, allowing healthcare providers to focus on patient care rather than administrative tasks. The service can significantly reduce administrative burden while ensuring proper reimbursement.
The billing service includes:
- Expert handling of claims submission to Medicare, Medicaid, and private insurance carriers
- 24/7 billing support from knowledgeable staff
- Reduced up-front costs for both facilities and patients
- Direct management of insurance communications and follow-up
As a Medicare-accredited company backed by a publicly traded corporation, Compression Solutions maintains strict ethical and safety standards in its billing practices. Its lymphedema billing program is based on 30+ years as a durable medical equipment (DME) supplier and medical biller.
Download Our LTA Billing Guide
Learn about billing for lymphedema compression garments and the documentation required for reimbursement under the Lymphedema Treatment Act (LTA).
Looking Ahead
The Lymphedema Treatment Act represents a significant step forward in improving access to essential compression therapy for patients with lymphedema.
For more information about compression garment billing services or to establish a billing relationship, healthcare providers can contact Compression Solutions.
