Billing and Coding: Lymphedema Decongestive Treatment

Medicare covers necessary components of lymphedema decongestive treatment (MLD and CDT) but excludes treatment for tissue edema from other etiologies (e.g., chronic venous insufficiency, congestive heart failure, acute infection). Coverage requires documentation of a lymphedema diagnosis with recent change, prior unsuccessful conservative therapies, services provided by a qualified clinician demonstrating that therapist-level skills are needed, and treatment aimed at transferring care to the patient/caregiver (generally within 1–3 weeks), with benefits considered temporary unless home maintenance continues.