2025 HCPCS code A6609

Gradient compression bandaging supply, not otherwise specified.

The code should only be used when a more specific HCPCS code is not available.Appropriate documentation is crucial for reimbursement.The quantity of bandages must be accurately reported.

Modifiers may be applicable depending on the specific circumstances and payer requirements. For example, modifiers could indicate the location (e.g., left or right side), or multiple procedures. Consult payer guidelines for applicable modifiers.

Medical necessity for A6609 is established by the presence of lymphedema, edema (swelling), or other conditions requiring gradient compression therapy, as supported by clinical documentation showing the patient's condition and the need for the specific type of bandage.

The clinical responsibility lies with the physician or qualified healthcare professional who orders and oversees the application of the compression bandaging to manage lymphedema or edema.

IMPORTANT Similar codes include A6549 (Gradient compression garment, not otherwise specified), A6584 (Gradient compression wrap with adjustable straps, not otherwise specified), and A6593 (Accessory for gradient compression garment or wrap with adjustable straps, not otherwise specified).These codes should be used when a more specific code is available.

In simple words: This code is for a special bandage that squeezes more tightly in one area than another to help reduce swelling.It's used when there isn't a more specific code for the type of bandage.

This HCPCS code represents a gradient compression bandaging supply that does not have a more specific code.Gradient compression involves tighter squeezing at one end of the garment and less at the other, encouraging lymph drainage in lymphedema or fluid return to reduce edema.

Example 1: A patient presents with lower extremity lymphedema post-mastectomy. The physician orders custom gradient compression bandages to manage the swelling. A6609 would be used to bill for the supply, specifying the type and quantity in the claim narrative., A patient with chronic venous insufficiency experiences significant lower leg edema. The physician prescribes a multi-layered gradient compression bandaging system to improve venous return.A6609 would be reported for the supplies used, detailing each component separately if necessary., A patient with lipoedema seeks treatment for significant lower body swelling. The physician and certified lymphedema therapist utilize a combination of manual lymphatic drainage and gradient compression bandaging.A6609 is reported for the supply of custom-fit bandages.

** This code is intended to cover supplies not otherwise specified within the HCPCS system.Always ensure accurate and complete documentation to support medical necessity.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.