How To Use HCPCS Code A6537

HCPCS code A6537 describes a specific type of gradient compression stocking. This code is used to identify full-length or chap-style stockings that provide a compression level of 30-40 mmHg. Each stocking is considered a separate unit and is billed individually.

1. What is HCPCS A6537?

HCPCS code A6537 is used to identify a specific type of gradient compression stocking. These stockings are designed to apply pressure to the legs, promoting better blood flow and reducing swelling. The compression level of 30-40 mmHg indicates the amount of pressure exerted by the stocking. This code is used to bill for each individual stocking provided to the patient.

2. Official Description

The official description of HCPCS code A6537 is “Gradient compression stocking, full length/chap style, 30-40 mmHg, each.” This description accurately reflects the type of stocking and the compression level it provides. The short description for this code is “Gc stocking full lngth 30-40.”

3. Procedure

1. Measure the patient’s leg to determine the appropriate size of the compression stocking.
2. Select a full-length or chap-style stocking based on the patient’s needs and preferences.
3. Instruct the patient on how to properly wear and care for the compression stocking.
4. Provide the patient with the prescribed number of stockings, ensuring that each stocking is individually packaged.

4. When to use HCPCS code A6537

HCPCS code A6537 should be used when providing patients with gradient compression stockings that meet the specific criteria outlined in the code description. These stockings are typically prescribed for individuals with conditions such as lymphedema or chronic venous insufficiency. It is important to ensure that the compression level of 30-40 mmHg is appropriate for the patient’s needs.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A6537, healthcare providers should include the following documentation:

• Prescription or order for the compression stockings
• Measurement of the patient’s leg to determine the appropriate size
• Documentation of the patient’s condition or diagnosis warranting the use of compression stockings
• Itemized invoice or receipt indicating the quantity of stockings provided

Providers should follow the specific billing guidelines set forth by Medicare or other insurance carriers to ensure proper reimbursement for the service.

6. Historical Information and Code Maintenance

HCPCS code A6537 was added to the Healthcare Common Procedure Coding System on January 01, 2006. As of the effective date of January 01, 2024, this code is subject to carrier judgment for coverage. There have been no significant maintenance actions taken for this code since its addition.

7. Medicare and Insurance Coverage

Medicare and other insurance carriers may provide coverage for HCPCS code A6537, subject to their specific guidelines and policies. The pricing indicator code for this code is 40, which indicates that it is classified as a lymphedema compression treatment item. The multiple pricing indicator code is A, indicating that the code is not applicable as HCPCS priced under one methodology.

8. Examples

Here are five examples of when HCPCS code A6537 should be billed:

1. A patient with lymphedema receives a prescription for two full-length gradient compression stockings with a compression level of 30-40 mmHg.
2. An individual with chronic venous insufficiency requires a chap-style compression stocking with a compression level of 30-40 mmHg.
3. A patient undergoes surgery and is at risk of developing deep vein thrombosis. They are prescribed a pair of full-length gradient compression stockings for post-operative use.
4. An individual with a history of leg ulcers is recommended to wear compression stockings to promote healing and prevent recurrence.
5. A patient with varicose veins is advised to wear compression stockings during long periods of standing or sitting to alleviate symptoms.