Payer Requirements and Reimbursement
General Guidelines for Coverage by Insurers
Most Insurance plans provide coverage of Compression Devices and Appliances provided by Wright therapy Products, Inc.
- E0652 – Wright 52 Gradient Pneumatic Compression Pump
- E0651 – Wright 51 Non-Gradient Pneumatic Compression Pump
- E0667 – Leg extremity (leg) appliance
- E0668 – Upper extremity (arm) Appliance
Covers Calibrated Gradient Compressors and Appliances for the treatment of:
– Venous Insufficiency/Venous Ulcer
- Must document that other treatments, such as bandaging, compression stockings and exercise
- Failed to heal the wound for six consecutive months
– Lymphedema- Congenital, secondary, and post-mastectomy
- Must document that conservative therapy including the use of an E0651 not- calibrated gradient compressor, was tried and was not effective
NOTE: Medicare and many commercial insurers require extensive and precise treatment notes from the patient’s medical record to approve coverage of an E0652
Most commercial Insurers cover calibrated Gradient compression Pumps and Appliances for the treatment of:
– Venous Insufficiency/Venous Ulcers
– Lymphedema – Congenital, secondary, post-mastectomy, and other lymphedema
– Other edematous conditions
Many have adopted Medicare coverage and documentation guidelines.
To request an insurance coverage evaluation call 800-631-9535 or fax the following information to 724-695-0406:
- Insurance Information, i.e. Copy of the patient insurance card
- Patient Information, name phone, diagnosis, permission to contact, etc.
- Physicians order, prescription, and or treatment notes
NOTE: The guidelines above are general and do not assure coverage.