How To Use HCPCS Code A6589

HCPCS code A6589 describes a gradient pressure wrap with adjustable straps, specifically designed as a bra. This code is used to identify a specific type of compression garment used in the treatment of lymphedema. Lymphedema is a condition characterized by the accumulation of lymphatic fluid, resulting in swelling and discomfort. The use of compression garments, such as the gradient pressure wrap with adjustable straps, can help manage and reduce the symptoms of lymphedema.

1. What is HCPCS A6589?

HCPCS code A6589 is a specific code used to identify the gradient pressure wrap with adjustable straps, bra, each. This code is used in medical coding and billing to accurately document and bill for the provision of this particular compression garment. It is important for medical coders to correctly assign this code to ensure proper reimbursement and tracking of the use of this specific medical supply.

2. Official Description

The official description of HCPCS code A6589 is “Gradient pressure wrap with adjustable straps, bra, each.” This description accurately describes the specific compression garment that is being coded and billed for. The short description of this code is “Grad com wrap w straps bra,” which provides a concise summary of the item.

3. Procedure

1. The provider should assess the patient’s condition and determine the need for a gradient pressure wrap with adjustable straps, bra.
2. The provider should measure the patient’s body to ensure the proper fit of the compression garment.
3. The gradient pressure wrap with adjustable straps, bra should be applied to the affected area, ensuring that it provides the appropriate level of compression.
4. The adjustable straps should be adjusted to provide a comfortable and secure fit for the patient.
5. The provider should educate the patient on the proper use and care of the compression garment.

4. When to use HCPCS code A6589

HCPCS code A6589 should be used when a healthcare provider prescribes or provides a gradient pressure wrap with adjustable straps, bra to a patient for the treatment of lymphedema. This code is specific to this particular type of compression garment and should not be used for other types of garments or supplies. It is important to ensure that the patient meets the eligibility criteria for the use of this code, as determined by the healthcare provider.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A6589, healthcare providers should ensure that the necessary documentation is included to support the medical necessity of the compression garment. This may include the patient’s diagnosis of lymphedema, the provider’s prescription or order for the garment, and any other relevant clinical documentation. It is important to follow the billing guidelines set forth by the payer, including any specific requirements for documentation or coding modifiers.

6. Historical Information and Code Maintenance

HCPCS code A6589 was added to the Healthcare Common Procedure Coding System on January 01, 2024. As of this date, there have been no maintenance actions taken for this code. This means that there have been no updates or revisions to the code since its addition. It is important for medical coders to stay updated on any changes or updates to HCPCS codes to ensure accurate coding and billing practices.

7. Medicare and Insurance Coverage

HCPCS code A6589 falls under the pricing indicator code 40, which indicates that it is a lymphedema compression treatment item. The multiple pricing indicator code for this code is A, which means it is not applicable as HCPCS priced under one methodology. Medicare and other insurance providers may cover the cost of the gradient pressure wrap with adjustable straps, bra for eligible patients with a diagnosis of lymphedema. However, coverage may vary depending on the specific insurance plan and the medical necessity of the garment.

8. Examples

Here are five examples of when HCPCS code A6589 should be billed:

1. A patient with a diagnosis of lymphedema in the upper extremities is prescribed a gradient pressure wrap with adjustable straps, bra to manage their symptoms.
2. A patient who has undergone lymph node removal surgery as part of their cancer treatment is fitted with a gradient pressure wrap with adjustable straps, bra to prevent or manage lymphedema.
3. A patient with a history of chronic lymphedema in the breast area is provided with a gradient pressure wrap with adjustable straps, bra to alleviate discomfort and reduce swelling.
4. A patient with lymphedema in the lower extremities is prescribed a gradient pressure wrap with adjustable straps, bra to improve circulation and reduce fluid buildup.
5. A patient who has recently completed radiation therapy for breast cancer is fitted with a gradient pressure wrap with adjustable straps, bra to manage potential lymphedema symptoms.