Insurance Coverage Requirements
IOC Home Medical can bill your private insurance for local Utah claims with a prescription and the appropriate documentation.
THE LEADER IN LYMPHEDEMA
AND VENOUS INSUFFICIENCY TREATMENT
Steps for Ordering Pneumatic Compression Device for Medicare and Private Insurance Patients
Please Submit:
Prescription order form signed or Physician orders
Patient Demographics and Insurance Information
Two (2) patient notes that are at least 28 days apart and have the below documentation requirements:
Diagnosis- Q82.0 – Primary Lymphedema
I89.0 – Secondary Lymphedema (CVI, Cancer, Scarring, Tumor)
I87.2 – CVI (with/without wounds) (6 Months of Documentation)
Symptoms- Staging of Lymphedema (1,2, or 3), Girth measurements1+ 2+ 3+ pitting edema, Volume measurement
(Need 1 of the above symptoms in patient notes)
Conservative Care- Elevation, Compression – Class 1 Stockings or Bandaging, Exercise
(Need documentation that all of the above conservative care requirements failed in patient notes)
No significant improvement- Symptoms either remain or persist after attempting conservative care
AND VENOUS INSUFFICIENCY TREATMENT