Like most folks, I am thrilled that patients with lymphedema might have access to much needed supplies like compression bandages, stockings and garments, thanks to the Lymphedema Treatment Act! However, whenever a new “benefit” is added by Medicare, it invariably has unintended consequences . Certainly, it means that for awhile there will be some confusion about how to bill correctly. Several issues have already arisen about obtaining supplies from a DME, and I will make a few blog posts to get a dialogue going, starting with this one.
I think clinicians need to pay special attention to the sentence that I highlighted in yellow.
This language seems to clearly state that if a patient is being treated in an office/clinic setting with bandaging being applied as part of active treatment, it is not possible to order bandages from a DME on that date of service for use in the home. Someone is not going to get paid, and it will either be the DME or the hospital that provided the service. There are some issues to pay attention to with regard to patients with active venous ulcers when ordering stockings or garments. I will post an upcoming blog about my concerns. I do not have “the answer” – I am still trying to understand the questions. Maybe you all can help me.
“We appreciate the comments on a variety of different viewpoints on bandaging, bundling payments and how to approach payment for therapists and other skilled professionals. We understand and agree that bandaging may be provided at different phases of the beneficiary’s treatment of lymphedema and the use of bandaging can continue at various stages of lymphedema as long as medically necessary. We are clarifying that payment for compression bandaging systems under this benefit category is not limited to Phase 1 (acute or decongestive therapy) but is also available under Phase 2 (maintenance therapy). With regards to payment, we note that currently a therapist who applies compression bandaging supplies during Phase 1 of treatment can bill for the service of applying the bandages using CPT codes 29581 and 29584. It is important to note, however, that if the CPT codes are billed and paid for a particular date of service, then billing for the bandaging supplies used during that date of service using the HCPCS A codes is not allowed and would be denied as it would result in duplicate payment of the supplies since the Medicare payment amounts for codes 29581 and 29584 include payment for the compression bandaging supplies.”