2025 HCPCS code A6557
(Active) Effective Date: N/A Revision Date: N/A Medical Supplies - Compression Garments and Stockings Medical and Surgical Supplies Feed
Supply of a custom-fitted, thigh-length gradient compression stocking (30-40 mmHg).
Modifiers may be applicable depending on the specific circumstances. For example, a modifier may be needed to indicate bilateral application or other relevant factors.
The medical necessity for a custom-fitted gradient compression stocking is established by the presence of lymphedema or a similar condition causing significant swelling and compromised lymphatic drainage.The custom fit ensures the optimal level of compression needed for effective treatment.Appropriate documentation must support this necessity.
Supply of the compression stocking; fitting may be included depending on payer policies.
In simple words: This code covers the cost of a special stocking made to fit a patient's leg.The stocking provides graduated pressure to help drain fluid from legs affected by lymphedema (swelling due to a lymphatic system problem).
This HCPCS code represents the provision of a custom-fitted, thigh-length gradient compression stocking designed to apply a pressure of 30-40 mmHg.Gradient compression, where pressure is greater at one end than the other, is used to encourage lymphatic drainage in patients with lymphedema.Custom-fitted garments are uniquely sized and shaped to the affected body part for accurate compression.
Example 1: A patient with lymphedema in their right leg is prescribed a custom-fitted thigh-high gradient compression stocking to manage swelling and improve lymphatic drainage. Code A6557 is used to bill for the supply of this stocking., A patient post-mastectomy experiences lymphedema in their left arm. A custom-fitted sleeve is created and applied.The specific measurements are recorded, and A6557 is billed for the custom-made compression garment., A patient with chronic venous insufficiency and significant leg edema is fitted for a thigh-high custom gradient compression stocking. After measuring the limb and fitting the compression garment, A6557 is used for billing.
* Patient's medical record documenting the diagnosis of lymphedema or other condition necessitating compression therapy.* Detailed measurements of the affected limb(s) used to create the custom stocking.* Description of the stocking type (thigh-length, gradient compression) and pressure (30-40 mmHg).* Documentation supporting medical necessity for the custom-fitted garment.
** The pressure range (30-40 mmHg) is a key specification.Ensure the documentation accurately reflects the pressure provided by the custom-made stocking.Clarify whether fitting is included in the supply charge.
- Payment Status: Active
- Specialties:Lymphology, Vascular Surgery, Oncology, Physical Therapy
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgery Center, Home Health Agency