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

We are adding new insurances all the time. Call or come into the store for specific insurance questions.

801-226-4741

We are here to help you

801-226-4741