Lymphedema Decongestive Treatment

Medicare covers medically necessary hands-on Manual Lymphatic Drainage (CPT 97140) and short courses of patient/caregiver compression bandaging education (CPT 97535, typically ≤3 sessions) for patients with a documented diagnosis of lymphedema when recent condition changes and prior unsuccessful conservative therapies are documented and services are delivered by qualified clinicians. Compression bandage application itself is considered unskilled and not separately payable for lymphedema (high-compression bandage codes 29581/29584 are not to be billed for unskilled lymphedema bandaging, except when used for wound treatment), and ongoing services that can be performed by the patient/caregiver are maintenance care and not covered as skilled therapy. Documentation must show objective, sustainable improvement (usually within 1–10 days) and support medical necessity throughout the episode of care.

"Diagnosis of lymphedema documented in the medical record (not tissue edema from other etiologies such as chronic venous insufficiency, congestive heart failure, or acute infection)."