How To Use HCPCS Code A6552

HCPCS code A6552 describes a specific type of compression stocking that is used to provide gradient compression below the knee. This code is used to identify and bill for the supply of these stockings, which have a compression level of 30-40 mmHg. In this article, we will explore the details of HCPCS code A6552, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS A6552?

HCPCS code A6552 is used to identify gradient compression stockings that are worn below the knee and have a compression level of 30-40 mmHg. These stockings are designed to provide therapeutic compression to the lower leg and help improve blood circulation. They are commonly used in the treatment of conditions such as lymphedema, venous insufficiency, and deep vein thrombosis.

2. Official Description

The official description of HCPCS code A6552 is “Gradient compression stocking, below knee, 30-40 mmHg, each.” This description accurately reflects the purpose and specifications of the compression stockings covered by this code.

3. Procedure

1. Measure the patient’s leg to determine the appropriate size of the compression stocking.
2. Instruct the patient on how to properly wear and remove the stocking.
3. Ensure that the stocking is snug but not too tight, as proper fit is essential for effective compression.
4. Educate the patient on the importance of wearing the stocking consistently and following any additional care instructions.

4. When to use HCPCS code A6552

HCPCS code A6552 should be used when providing or billing for gradient compression stockings that meet the specific criteria outlined in the code description. These stockings should be worn below the knee and have a compression level of 30-40 mmHg. It is important to ensure that the patient’s condition and medical necessity align with the use of these stockings.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A6552, healthcare providers should ensure that the following documentation requirements are met:

• Prescription or order for the compression stockings from a qualified healthcare professional.
• Documentation of the patient’s condition or diagnosis that justifies the need for the stockings.
• Proof of delivery or dispensing of the stockings to the patient.
• Itemized invoice or claim form that includes the HCPCS code A6552, quantity, and any applicable modifiers.

6. Historical Information and Code Maintenance

HCPCS code A6552 was added to the Healthcare Common Procedure Coding System on January 01, 2024. As of its addition date, there have been no maintenance actions taken for this code. This indicates that there have been no updates, revisions, or terminations for HCPCS code A6552 since its inclusion in the coding system.

7. Medicare and Insurance Coverage

HCPCS code A6552 is eligible for coverage and reimbursement by Medicare and other insurance providers. 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 it is not applicable as HCPCS priced under one methodology. Providers should refer to the specific guidelines and policies of each payer to determine the reimbursement rates and coverage criteria for HCPCS code A6552.

8. Examples

Here are five examples of scenarios in which HCPCS code A6552 should be billed:

1. A patient with a diagnosis of lymphedema requires below-knee gradient compression stockings with a compression level of 30-40 mmHg.
2. A patient with venous insufficiency is prescribed below-knee compression stockings with a compression level of 30-40 mmHg to manage their condition.
3. A patient undergoing treatment for deep vein thrombosis needs below-knee gradient compression stockings to aid in the prevention of blood clots.
4. A healthcare provider dispenses below-knee compression stockings to a patient who recently underwent surgery to promote healing and reduce swelling.
5. A patient with chronic leg swelling due to a medical condition requires below-knee gradient compression stockings for ongoing management and symptom relief.